臂丛神经损伤规范化康复治疗的临床研究*

关键词：臂丛神经损伤  规范化康复  推拿  物理治疗

Keywords:brachial plexus injury  standardized rehabilitation  tuina therapy  physical therapy

摘要：

      摘要 目的：观察对照规范化康复治疗对臂丛神经损伤的临床疗效观察。 方法：将50例臂丛神经损伤患者随机分为两组，去除脱落患者后分为治疗组（n=25，其中全臂丛神经损伤13例，上干神经损伤5例，束支部神经损伤7例）和对照组（n=22，其中全臂丛神经损伤14例，束支部神经损伤8例），治疗组予规范化康复治疗、低频脉冲点刺激、中频电疗、推拿手法和运动功能训练。对照组自行家中神经肌肉电刺激，体疗。30d为1个疗程。治疗4个疗程后按照臂丛神经损伤功能评定标准评估臂丛神经功能恢复情况，予视觉模拟评分法（VAS）来评估疼痛强度变化。 结果：两组经对照发现，在臂丛神经功能恢复方面，治疗组的臂丛神经功能与治疗前相比差异有显著性意义(P<0.05)；对照组治疗前后比较差异无显著性意义(P>0.05)，“全臂丛神经损伤”两组4个疗程后比较有显著性意义(P<0.05)；在VAS疼痛评估方面，两组治疗前后比较，差异无显著性意义(P>0.05)。 结论：规范化康复治疗对臂丛神经损伤患者有确定的康复疗效，可促进功能恢复。

Abstract:

      Abstract Objective: To observe the clinical therapeutic effect of standardized rehabilitation in treating dysfunction after brachial plexus injury. Method: Fifty cases with dysfunction after brachial plexus injury were divided into two groups randomly. In the follow up courses, 3 cases were lost. The treatment group, which totaled 25 patients (including 13 cases of complete brachial plexus, 5 cases of upper trunk and 7 cases of branch brachial plexus), was treated with standardized rehabilitation including low frequency pulsed electric stimulation, medium frequency electrotherapy, tuina therapy and motor function training. The controlled group, which totaled 22 patients (including 14 cases of complete brachial plexus and 8 cases of branch brachial plexus), was treated with home-in low frequency pulsed electric stimulation and motor function training. All the treatments proceeded 30d as a course and 4 courses at all. The rehabilitation effect was evaluated according to the brachial plexus function evaluation standard, while pain according to visual analogue scale（VAS）. Result: The effects of two groups were compared and analyzed. The scores of brachial plexus function evaluation in treatment group before and after treatment had statistical differences (P<0.05), while that in controlled group had no statistical difference(P>0.05). The scores of brachial plexus function evaluation had statistical differences (P<0.05) between the two “complete brachial plexus” groups after 4 courses. VAS scores between the two groups had no statistical difference(P>0.05). Conclusion: Standardized rehabilitation was more effective in treating dysfunction after brachial plexus injury compared with nonstandardized rehabilitation.