强化肌力训练对脊髓AVM术后截瘫患者功能独立的影响  

The effect of intensive muscle strengthening exercise on functional independence of paraplegic patients post spinal cord AVM surgery

作　　者：石坚[1] 刘利辉[1] 刘宁富[1] 程金水[1] 黄国强[1] 谢振容[1] 李华[1] 刘敏[1] 

机构地区：[1]第一军医大学珠江医院谊侨科康复中心,广州510282

出　　处：《中华物理医学与康复杂志》2002年第6期328-330,共3页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的　探讨以强化肌力训练为主的康复治疗对脊髓动静脉畸形 (Arteriovenousmalformation ,AVM)术后截瘫患者独立生活能力的影响。方法　 1 1例脊髓AVM术后截瘫患者 ,分为康复组和对照组。治疗组 6例 ,术后进行躯干和下肢肌群强化肌力训练 6～ 1 2个月 ,辅以神经肌肉电刺激 ;对照组 5例 ,术后自然恢复。所有患者于康复治疗前、后及 1年后用脊髓损伤标准神经分类法 (thestandardneurologicalclassificationofspinalcordinjury,SNCSCI) ,功能独立性测量 (FunctionalIndependenceMeasure ,FIM) ,ASIA损伤评定表 (ASIA)评测病人损伤和功能独立情况。结果　治疗组患者经过 3～ 1 2个月治疗后 ,运动功能和功能独立能力比治疗前显著提高 (P <0 .0 1 ) ,1年后患者损伤程度和功能独立程度评测显示 ,治疗组明显优于对照组 (P <0 .0 1 )。结论　对脊髓AVM术后截瘫患者 ,应重视瘫痪下肢肌群和全身肌群的强化肌力训练 ,可用 1年以上的时间强化训练 ,挖掘潜力 ,使患者独立生活能力提高。Objective To investigate the influence of intensive muscle strengthening exercise on functional independence of paraplegic patients after the surgery for spinal arterio venous malformation (AVM). Methods Eleven paraplegic cases after spinal cord AVM surgery were divided into 2 group. Six cases in the rehabilitation group were treated with intensive muscle strengthening exercise over the trunk and lower limb and electric neuromuscular stimulation once a day for 6～12 months. Five cases in the control group were managed with the conventional method. All the cases were assessed with the Standard Neurological Classification of Spinal Cord Injury (SNCSCI),Functional Independence Measurement (FIM) and ASIA spinal cord injury assessment before and after treatment. Results The motor function and functional independence ability was much better in the rehabilitation training group than those of the control group ( P <0.01)1 year after the treatment. Conclusion For patients with paraplegia following the surgery for AVM of the spinal cord, intensive muscle strengthening exercise of the trunk and lower limbs is necessary; satisfactory outcome can usually be obtained after a long term rehabilitation training.

关 键 词：截瘫 动静脉畸形 肌力训练 功能独立性测量 脊髓动静脉畸形 

分 类 号：R493[医药卫生—康复医学]