胸腰椎骨折伴不完全性脊髓损伤患者的功能独立性水平及其影响因素  

Functional independence level of patients with thoracolumbar vertebral fractures complicated with incomplete spinal cord injury and influencing factors

作　　者：江波 杨菲[2] 程大力 武霄霄 JIANG Bo;YANG Fei;CHENG Dali;WU Xiaoxiao(Department of Rehabilitation Medicine,Suzhou Hospital of Anhui Medical University,Suzhou 234000;Department of Neurology,Suzhou Hospital of Anhui Medical University,Suzhou 234000)

机构地区：[1]安徽医科大学附属宿州医院康复医学科,宿州234000 [2]安徽医科大学附属宿州医院神经内科,宿州234000

出　　处：《颈腰痛杂志》2025年第1期39-44,共6页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的观察胸腰椎骨折伴不完全性脊髓损伤(ISCI)患者的功能独立性水平及其影响因素。方法选取2021年1月至2023年12月于本院进行术后康复治疗的胸腰椎骨折伴ISCI患者70例,采用中文版脊髓独立性评定量表(SCIM-Ⅲ)评估患者的功能独立性水平,以SCIM-Ⅲ评分为因变量,选取患者的社会人口学资料、临床资料及生化指标为自变量,采用多元线性回归分析患者功能独立性水平的影响因素。结果70例患者的SCIM-Ⅲ评分为39~75分,平均(57.44±7.21)分,其中自我照顾评分为(12.04±3.75)分,呼吸和括约肌管理评分为(25.17±6.36)分,移动评分为(20.23±4.71)分。不同文化程度、腰部疼痛程度、康复锻炼强度、ASIA分级、血尿素氮水平及血肌酐水平患者SCIM-Ⅲ评分比较差异有统计学意义(P<0.05),其中文化程度为大专及以上、腰部疼痛程度为无/轻度、康复锻炼强度为强患者的SCIM-Ⅲ评分较高(P<0.05),血尿素氮、血肌酐水平低的患者SCIM-Ⅲ评分较低(P<0.05)。Spearman相关性分析结果显示,患者的SCIM-Ⅲ评分与文化程度(r=0.853)、康复锻炼强度(r=0.926)、ASIA分级(r=0.869)、血尿素氮水平(r=0.605)、血肌酐水平(r=0.811)均呈正相关(P<0.05),与腰部疼痛程度(r=-0.694)呈负相关(P<0.05)。多元线性回归分析结果显示,文化程度、腰部疼痛程度、康复锻炼强度、ASIA分级、血尿素氮及血肌酐水平是胸腰椎骨折伴ISCI患者功能独立性水平的独立影响因素(P<0.05)。结论胸腰椎骨折伴ISCI患者的功能独立性水平普遍较低,文化程度、腰部疼痛程度、康复锻炼强度、损伤程度、血尿素氮及血肌酐水平与患者功能独立性水平有关,患者康复期间应加强对上述情况的关注与干预,提高其功能独立性水平。Objective To observe functional independence level of patients with thoracolumbar vertebral fractures complicated with incomplete spinal cord injury(ISCI)and influencing factors.Methods A total of 70 patients with thoracolumbar vertebral fractures and ISCI who underwent postoperative rehabilitation in the hospital from January 2021 to December 2023 were enrolled in this study.The Chinese version of the Spinal Cord Independence Measure-III(SCIM-III)was used to evaluate the patients’functional independence level.With SCIM-III score as the dependent variable,and the patients’sociodemographic data,clinical data and biochemical indicators as independent variables,multiple linear regression analysis was conducted to identify the factors influencing the patients’functional independence level.Results The SCIM-III score in this study was(57.44±7.21),ranged from 39 to 75.The self-care score,respiratory and sphincter management score,and mobility score were(12.04±3.75),(25.17±6.36),and(20.23±4.71),respectively.There were statistically significant differences in SCIM-III scores among patients with different education levels,different lower back pain degrees,different rehabilitation exercise intensity,different ASIA grades,different blood urea nitrogen levels,and different serum creatinine levels(P<0.05).Patients with education level of junior college or above,patients without or with mild lower back pain,patients with intense rehabilitation exercise,and patients with ASIA grade D had higher SCIM-III scores(P<0.05).Patients with low blood urea nitrogen level and low serum creatinine level had lower SCIM-III scores(P<0.05).Spearman correlation analysis results showed that the SCIM-III score was positively correlated with educational level(r=0.853),rehabilitation exercise intensity(r=0.926),ASIA grade(r=0.869),blood urea nitrogen level(r=0.605)and serum creatinine level(r=0.811)(P<0.05),but negatively correlated with the degree of lower back pain(r=-0.694)(P<0.05).The results of multiple linear regression analysis sho

关 键 词：胸腰椎骨折 不完全性脊髓损伤 功能独立性水平 影响因素 

分 类 号：R681.5[医药卫生—骨科学]