腹部高频深部振动疗法在颈、胸段脊髓损伤患者神经源性肠功能障碍康复中的作用  

Effect of high-frequency abdominal deep vibration therapy on neurogenic bowel dysfunction in patients with cervical and thoracic spinal cord injury

作　　者：周莉 毛二莉[1,2] 林娟 万春利[1,2] 黄俊豪 吴文杰 励建安[1,2] 李勇强 ZHOU Li;MAO Erli;LIN Juan(The First Affiliated Hospital of Nanjing Medical University,Nanjing,210029)

机构地区：[1]南京医科大学第一附属医院康复医学中心,江苏省南京市210029 [2]江苏省人民医院钟山康复分院 [3]南京医科大学第一附属医院河西分院 [4]南京体育学院研究生部

出　　处：《中国康复医学杂志》2024年第12期1834-1838,共5页Chinese Journal of Rehabilitation Medicine

基　　金：无锡“太湖人才计划”医疗卫生高层次人才项目(WXTTP2020008)。

摘　　要：目的:探讨腹部高频深部振动疗法在颈、胸段脊髓损伤(spinal cord injury,SCI)患者神经源性肠功能障碍(neurogenic bowel dysfunction,NBD)康复作用的效果评价。方法:选取在我院住院治疗的颈、胸段SCI后NBD患者59例,采用随机对照设计,使用随机数字表法将患者分为对照组30例,观察组29例。两组患者均接受标准NBD康复护理,对照组额外进行了手动腹部按摩疗法,观察组接受腹部高频深部振动疗法,研究周期4周。比较两组患者入组前后国际脊髓损伤肠道功能评价(2.0版)、大便的性状(Bristol粪便分型法)、生存质量测定量表评分(QOL-BRE)及肠道相关并发症(药物依赖、腹痛/腹胀、漏粪发生、不完全性肠梗阻)发生率。结果:观察组干预后国际脊髓损伤肠道功能评分分级优于对照组(P<0.01);观察组干预后排便性状Bristol粪便分型Ⅳ(理想型:香蕉状便)(62%)高于对照组(26.7%)(P<0.01);观察组干预后生存质量评分显著高于对照组评分(P<0.05);观察组干预后肠道相关并发症(药物依赖6%、腹痛/腹胀0、漏粪发生0、肠梗阻0)低于对照组(药物依赖50%、腹痛/腹胀30%、漏粪发生27%、肠梗阻17%)(P<0.05)。结论:腹部高频深部振动疗法可促进颈、胸段SCI神经源性肠患者肠道功能恢复,减少对药物依赖,降低肠道相关并发症,提高其生存质量,操作简易方便高效。Objective:To explore the effect of high-frequency abdominal deep vibration therapy in the rehabilitation of neurogenic bowel dysfunction(NBD)in patients with cervical and thoracic spinal cord injury.Method:A total of 59 hospitalized patients with NBD after cervical and thoracic spinal cord injury were selected and divided into control group(n=30)and the intervention group(n=29)by a randomized controlled trial design.The control group received the standard NBD rehabilitation nursing combined with manual abdominal massage therapy,while the intervention group received standard care supplemented with high-frequency abdominal deep vibration therapy.The study period was 4 weeks.The outcomes were assessed using the International Spinal Cord Injury Bowel Function Date Set(version 2.0),Bristol stool classification,quality of life brief questionnaire(QOL-BRE)and bowel-related complications(medication dependence,abdominal pain/bloating,fecal incontinence,and incomplete bowel obstruction)before and after the intervention.Result:After intervention,the international spinal cord injury bowel function scores in the intervention group were better than that of the control group(P<0.01).The proportion of patients achieving ideal stool consistency(Type IV,banana-shaped stool)was higher in the intervention group(62%)compared to the control group(26.7%)(P<0.01).The quality of life score of the intervention group was significantly higher than that of the control group after intervention(P<0.05);The bowel-related complications(medication dependence 6%,abdominal pain/bloating 0%,fecal leakage 0%,intestinal obstruction 0%)in the intervention group were lower than those in the control group(medication dependence 50%,abdominal pain/bloating 30%,fecal leakage 27%,intestinal obstruction 17%)(P<0.05).Conclusion:High-frequency abdominal deep vibration therapy is effective in promoting the recovery of bowel function,reducing medication dependence,lowering the incidence of bowel-related complications,and improving quality of life in patients with

关 键 词：高频深部振动疗法 脊髓损伤 神经源性肠功能障碍 腹部按摩 便秘 

分 类 号：R651.2[医药卫生—外科学] R493[医药卫生—临床医学]