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脊柱的脱位或骨折所致脊髓损伤的发病率和致残率呈逐渐增高的趋势,存活者往往留有不同程度的肢体功能障碍,病人的劳动能力丧失,生存质量受到严重影响。统计表明我国现有超过百万人罹患此病,给家庭和社会带来了极大的心理和经济负担[1]。所以通过积极的康复训练最大限度地提高病人的生存质量,恢复病人的残存功能,能极大地减轻家庭和社会的负担。目前还没有一种方法能够完全解决脊髓损伤遗留后遗症所引起的问题。对于脊髓损伤后的康复目前主要采用高压氧、功能性电刺激、翻身转移训练、本体感觉神经肌肉促进技术、站立及平衡杠内训练、针灸、按摩、轮椅训练、心理干预等。本研究旨在探讨蛛网膜下腔注射甲泼尼龙对脊髓损伤后感觉运动能力的影响。现作报道。
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2组在治疗期间均未发生不良事件。治疗前2组病人ASIA 评分差异无统计学意义(P>0.05)。治疗后8周,2组 ASIA评分均明显高于治疗前(P<0.01),且治疗后观察组评分明显高于对照组(P<0.01)(见表 1)。
分组 n 感觉评分 运动评分 治疗前 观察组 68 31.3±17.1 97.2±19.9 对照组 63 32.1±15.2 99.2±23.3 t — 0.28 0.53 P — >0.05 >0.05 治疗8周后 观察组 68 89.8±19.3** 152.8±21.3** 对照组 63 70.1±17.2** 128.3±21.7** t — 6.15 6.52 P — <0.01 <0.01 组内配对t检验:**P<0.01 表 1 2组病人治疗前后ASIA 评分比较(x±s;分)
鞘内注射甲泼尼龙对不完全脊髓损伤康复的疗效分析
Efficacy of the intrathecal injection of methylprednisolone in the rehabilitation of incomplete spinal cord injury
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摘要:
目的探讨蛛网膜下腔注射甲泼尼龙后对脊髓损伤后康复效果的影响。 方法选取颈脊髓损伤后不完全截瘫行康复治疗的病人 131例,随机分为观察组 68 例和对照组 63例。2组病人均接受普通康复治疗。观察组在普通康复治疗基础上,接受蛛网膜下腔注射甲泼尼龙治疗。治疗前后按美国脊髓损伤协会(ASIA)标准对2组病人进行评估。 结果治疗前2组病人ASIA 评分差异无统计学意义 (P>0.05)。治疗后8周,2组ASIA评分均明显高于治疗前(P<0.01),且观察组评分明显高于对照组(P<0.01)。 结论甲泼尼龙鞘内注射有助于提高脊髓损伤病人的康复疗效。 Abstract:ObjectiveTo observe the effects of intrathecal injection of methylprednisolone in the rehabilitation of incomplete spinal cord injury. MethodsOne hundred and thirty-one incomplete paraplegia patients with spinal cord injury were randomly divided into the observation group(68 cases) and control group(63 cases).Two groups were treated with the common rehabilitation method, and the observation group was additionally treated with intrathecal injection of methylprednisolone.Two groups were evaluated before and after treatment according to the American Spinal Injury Association(ASIA) criteria. ResultsThere was no statistical significance in ASIA score between two groups before treatment(P>0.05).After 8 weeks of treatment, the ASIA scores in two groups were significantly higher than that before treatment(P<0.01), and the scores in observation group were significantly higher than those in the control group(P<0.01). ConclusionsThe intrathecal injection of methylprednisolone can significantly improve the postoperative rehabilitation effects in patients with spinal cord injury. -
表 1 2组病人治疗前后ASIA 评分比较(x±s;分)
分组 n 感觉评分 运动评分 治疗前 观察组 68 31.3±17.1 97.2±19.9 对照组 63 32.1±15.2 99.2±23.3 t — 0.28 0.53 P — >0.05 >0.05 治疗8周后 观察组 68 89.8±19.3** 152.8±21.3** 对照组 63 70.1±17.2** 128.3±21.7** t — 6.15 6.52 P — <0.01 <0.01 组内配对t检验:**P<0.01 -
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