高压氧联合体外冲击波治疗脑卒中后肩手综合征的疗效和安全性分析  

Efficacy and safety analysis of hyperbaric oxygen combined with extracorporeal shock wave on shoulder-hand syndrome after stroke

作　　者：鹿梁燕[1] 赵常宝[1] 李晓慧[1,2] 冀亚飞[1] 郝雅丽[1] Lu Liangyan;Zhao Changbao;Li Xiaohui;Ji Yafei;Hao Yali(Department of Rehabilitation Medicine,Heji Hospital Affiliated to Changzhi Medical College of Shanxi Province,Changzhi 046000,China;Department of Neurology,Heji Hospital Affiliated to Changzhi Medical College of Shanxi Province,Changzhi 046000,China)

机构地区：[1]山西省长治医学院附属和济医院康复医学科,长治046000 [2]山西省长治医学院附属和济医院神经内科,长治046000

出　　处：《中华航海医学与高气压医学杂志》2023年第5期592-596,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：长治医学院附属和济医院“2020科研孵育项目”(202008)。

摘　　要：目的探讨高压氧联合体外冲击波治疗脑卒中后肩手综合征的疗效和安全性。方法选取2020年1月至2022年8月于山西省长治医学院附属和济医院康复医学科和神经内科进行治疗的150例脑卒中后肩手综合征患者,按照随机数字表法分为Maitland手法组、体外冲击波组及高压氧联合体外冲击波组,每组50例,比较3组患者治疗前后的上肢运动功能、生活能力、疼痛程度及并发症发生情况。结果3组患者治疗后的改良Fugl-Meyer评定量表(FMAS)上肢版块和改良Barthel指数评定量表(MBI)评分均高于治疗前,疼痛视觉模拟评分法(VAS)评分低于治疗前,差异有统计学意义(P<0.001);3组患者治疗后的FMAS(上肢版块)、MBI及VAS评分差异有统计学意义,多重比较显示高压氧联合体外冲击波组的FMAS(上肢版块)和MBI评分显著高于Maitland手法组和冲击波组,VAS评分显著低于后者,差异均有统计学意义(P<0.001)。3组患者的并发症症状轻,且均在短期内明显好转,差异无统计学意义(P=0.411)。结论高压氧联合体外冲击波对脑卒中后肩手综合征患者有较好的临床疗效和较高的安全性。Objective To investigate the efficacy and safety of hyperbaric oxygen(HBO)combined with extracorporeal shock wave in the treatment of shoulder-hand syndrome after stroke.Methods A total of 150 patients with shoulder-hand syndrome after stroke,who were treated in the department of rehabilitation medicine and the department of neurology of Heji Hospital Affiliated to Changzhi Medical College of Shanxi Province from January 2020 to August 2022,were selected and divided into Maitland manipulation group,extracorporeal shock wave group,and HBO combined with extracorporeal shock wave group,with 50 cases in each group.The upper extremity motor function,activities of daily living,pain severity,and occurrence of complications before and after treatment in the three groups were compared.Results After treatment,the scores of the upper extremity motor measured by the modified Fugl-Meyer assessment scale(FMAS)and the scores of the modified Barthel index(MBI)of the three groups were higher than those before treatment,while the visual analog scale(VAS)scores were lower than those before treatment,and the differences were statistically significant(P<0.001).There were statistically significant differences in the scores of FMAS for the upper extremity motor,MBI scores,and VAS scores after treatment among the three groups.Post-hoc multiple comparisons showed that the scores of FMAS for the upper extremity motor and MBI scores in the HBO combined with extracorporeal shock wave group were significantly higher than those of the other two groups,while the VAS score of the HBO combined with extracorporeal shock wave group was significantly lower than those of the other two groups,all with statistically significant differences(P<0.001).The complications in the three groups were all mild and obviously improved in the short term,the differences were not statistically significant(P=0.411).Conclusion HBO combined with extracorporeal shock wave has shown good clinical efficacy and high safety in patients with shoulder-hand syndrome after strok

关 键 词：高压氧 体外冲击波 脑卒中 肩手综合征 

分 类 号：R743.3[医药卫生—神经病学与精神病学]