CAJ | 학술논문

目的：观察应用经皮脉冲磁刺激脊柱T12-L1椎体水平（骶2～4脊髓）副交感节前神经，对促进截瘫患者胃肠蠕动，缓解便秘症状的影响。方法将52例患者按入院日期奇偶数分为两组。对照组进行常规护理，包括心理护理、药物干预、饮食结构、水平衡、下腹部按摩方法、灌肠、盆底肌训练及高压氧的治疗。干预组在常规护理的基础上，脊髓损伤早期行经皮脉冲磁刺激脊柱 T12-L1椎体水平（骶2-4脊髓）副交感节前神经，以促进受损排便神经功能的恢复。观察两组患者的排便情况和疗效。结果干预组除颈椎骨折脱位并高位截瘫1例、脊柱原发肿瘤侵犯脊髓马尾神经2例效果不明显外，有规律排便率为88．46％（23/26），而对照组患者仅为61．54％（16/26），两组比较差异有统计学意义（χ2＝5．026，P＜0．05）。干预组有效率为76．9％（20/26），明显高于对照组50．0％（13/26），两组比较差异有统计学意义（χ2＝4．046，P＜0．05）。结论通过经皮脉冲磁刺激骶髓2～4副交感节前神经，改善支配排便神经功能的恢复，为截瘫后便秘患者提供无痛、无创、简单的治疗方法，减少便秘给患者带来的不便及痛苦，提高患者生活的质量。
목적：관찰응용경피맥충자자격척주T12-L1추체수평（저2～4척수）부교감절전신경，대촉진절탄환자위장연동，완해편비증상적영향。방법장52례환자안입원일기기우수분위량조。대조조진행상규호리，포괄심리호리、약물간예、음식결구、수평형、하복부안마방법、관장、분저기훈련급고압양적치료。간예조재상규호리적기출상，척수손상조기행경피맥충자자격척주 T12-L1추체수평（저2-4척수）부교감절전신경，이촉진수손배편신경공능적회복。관찰량조환자적배편정황화료효。결과간예조제경추골절탈위병고위절탄1례、척주원발종류침범척수마미신경2례효과불명현외，유규률배편솔위88．46％（23/26），이대조조환자부위61．54％（16/26），량조비교차이유통계학의의（χ2＝5．026，P＜0．05）。간예조유효솔위76．9％（20/26），명현고우대조조50．0％（13/26），량조비교차이유통계학의의（χ2＝4．046，P＜0．05）。결론통과경피맥충자자격저수2～4부교감절전신경，개선지배배편신경공능적회복，위절탄후편비환자제공무통、무창、간단적치료방법，감소편비급환자대래적불편급통고，제고환자생활적질량。
Objective To observe the effect of percutaneous pulsedmagnetic stimulation of the preganglionic parasympathetic nervous system of spinal at T 12-L1 vertebral level (2-4 sacral spinal cord), in order to promote gastrointestinal peristalsis paraplegics and relieve symptoms of constipation .Methods Totals of 52 patients were divided into two groups by their admission date .The control group were applied the routine nursing care, including the psychology nursing care , drug intervention, diet, water balance, lower abdominal massage therapy, enema, pelvic floor muscle training and hyperbaric oxygen therapy .Based on the routine care, the intervention group was given the early percutaneous spinal cord pulsed magnetic stimulation of the preganglionic parasympathetic nerves of the spine at T 12 -L1 vertebral level ( 2 -4 sacral spinal cord ) . Results In the intervention group , 1 patient had cervical fracture and dislocation;2 patients had tumor invasion of the primary caudaequina of spinal cord.88.46%(23/26) patients had regular bowel movements.In the control group, only 61.54% (16/26) patients had regular bowel movements.The difference was statistically significant (χ2 =5.026,P<0.05).The effective rate of the intervention group was 76.9%(20/26), which was significantly higher than 50.0% (13/26) in the control group (χ2 =4.046,P<0.05).Conclusions Percutaneous pulsed magnetic stimulation of the parasympathetic preganglionic nerve can improve the recovery of neurological function and provide a simple , noninvasive and painless method to reduce the constipation and improve patients ’ quality of life.