CAJ | 학술논문

目的探讨高压氧(hyperbaric oxygen,HBO)综合治疗对不完全颈髓损伤术后恢复的影响.方法分析我院骨科2010年6月至2012年6月收治的78例因外伤引起的不完全颈髓损伤患者的临床资料,所有患者均有完整随访资料,年龄、性别、受伤部位、病情等方面差异无统计学意义,且所有患者在受伤2周内均行神经减压内固定术.经患者知情同意,并经医院伦理委员会批准,将患者分为HBO治疗组(HBO组)40例和非HBO治疗组(NHBO组)38例,术后NHBO组只采用常规治疗,HBO组在常规治疗的基础上辅以HBO治疗,于治疗前、治疗1个月、治疗3个月、治疗6个月及术后1年分别采用美国脊髓损伤协会(ASIA)评分及Barthel指数对患者脊髓功能及日常生活活动能力(ADL)进行评定.结果 HBO组和NHBO组总有效率分别为90.0％、78.9％,2组差异有统计学意义(P＜0.05);2组间ASIA评分及Barthel指数在治疗1个月、治疗3个月、治疗6个月及治疗1年的差异均有统计学意义(P＜0.05),HBO组疗效优于NHBO组;恢复最明显的时期为术后第1个月,在治疗1个月后,HBO组及NHBO组患者ASIA感觉、运动功能评分及Barthel指数评分均较治疗前明显改善,且HBO组评分显著优于NHBO组,差异有统计学意义(P＜0.01).结论 HBO综合治疗不完全颈髓损伤是安全、有效的;术后3个月内治疗持续的时间越长效果越好;术后前3个月脊髓功能的恢复最明显.正确的HBO治疗能有效促进脊髓功能恢复,降低致残率,明显提高患者的生活质量.
목적 탐토고압양(hyperbaric oxygen,HBO)종합치료대불완전경수손상술후회복적영향.방법 분석아원골과2010년6월지2012년6월수치적78례인외상인기적불완전경수손상환자적림상자료,소유환자균유완정수방자료,년령、성별、수상부위、병정등방면차이무통계학의의,차소유환자재수상2주내균행신경감압내고정술.경환자지정동의,병경의원윤리위원회비준,장환자분위HBO치료조(HBO조)40례화비HBO치료조(NHBO조)38례,술후NHBO조지채용상규치료,HBO조재상규치료적기출상보이HBO치료,우치료전、치료1개월、치료3개월、치료6개월급술후1년분별채용미국척수손상협회(ASIA)평분급Barthel지수대환자척수공능급일상생활활동능력(ADL)진행평정.결과 HBO조화NHBO조총유효솔분별위90.0％、78.9％,2조차이유통계학의의(P＜0.05);2조간ASIA평분급Barthel지수재치료1개월、치료3개월、치료6개월급치료1년적차이균유통계학의의(P＜0.05),HBO조료효우우NHBO조;회복최명현적시기위술후제1개월,재치료1개월후,HBO조급NHBO조환자ASIA감각、운동공능평분급Barthel지수평분균교치료전명현개선,차HBO조평분현저우우NHBO조,차이유통계학의의(P＜0.01).결론 HBO종합치료불완전경수손상시안전、유효적;술후3개월내치료지속적시간월장효과월호;술후전3개월척수공능적회복최명현.정학적HBO치료능유효촉진척수공능회복,강저치잔솔,명현제고환자적생활질량.
Objective To investigate the effects of comprehensive hyperbaric oxygen (HBO) therapy on the recovery of patients following surgery of incomplete cervical spinal injury.Methods A retrospective analysis was made on the clinical data of 78 cases of incomplete cervical spinal injury by trauma collected from the medical file of our hospital from June 2010 to June 2012.All the patients had complete follow-up medical data,and no statistical significance could be noted in age,gender,injury sites,seriousness of injury etc.In addition,all the patients underwent nerve decompression and internal fixation within 2 weeks after injury.With the knowledge and consent of the patients and following approval by the Hospital Ethics Committee,the patients were divided into the HBO group (40 cases) and non-HBO(NHBO)group (38 cases).Following surgery,the patients in the NHBO group were treated with only routine treatment,while the patients in the HBO group received HBO therapy in addition to routine treatment.American Spinal Cord Injury Association (ASIA) Scores and Barthel's Index (BI) were respectively used to evaluate the spinal cord function and their daily life activity,before treatment,1 month and 3 months after treatment,6 months and 1 year after surgery.Results Total effective rates for the HBO group and the NHBO group were 90.0％ and 78.9％,with statistical significance,when comparisons were made between the 2 groups (P ＜ 0.05).Following 1 month and 3 months of treatment,and after 6 months and l year of surgery,statistical significance could be noted in the scores of ASIA and BI between the 2 groups (P ＜ 0.05),with the therapeutic effect of the HBO group being superior to that of the NHBO group.Recovery was most obvious in the first month after surgery.One month after surgery,ASIA scores,motor function scores and Barthel scores for both the HBO group and the NHBO group were all significantly higher,as compared with those before treatment,with the scores of the HBO group being significantly superior than those of the NHBO group and with statistical significance (P ＜ 0.01).Conclusions Comprehensive HBO therapy was safe and effective for the treatment of incomplete cervical spinal injury.Clinical practice indicated that the longer the duration of treatment,the better the results,within 3 months after operation.Recovery of spinal cord function was most obvious,within the first 3 months after surgery.Proper HBO treatment could promote recovery of spinal cord function,decrease disability rate and improved the quality of life of the patients.