摘要
目的探讨鼠神经生长因子(mNGF)联合康复训练治疗急性脊髓损伤(ASCI)患者的临床效果。方法选择2013年2月至2016年12月于郑州市第十人民医院进行手术治疗的ASCI患者56例,根据术后治疗方法将患者分为观察组和对照组,每组28例。2组患者均给予常规对症支持治疗,对照组患者在对症支持治疗的基础上进行康复训练,康复训练于术后15d开始;在对照组患者治疗基础上,观察组患者给予注射用mNGF20μg,肌肉注射,每日1次;2组患者均30d为1个疗程,治疗2个疗程。分别于治疗前及治疗后1d、1a采用美国脊椎损伤协会(ASIA)评分标准评估2组患者的神经功能,并进行脊髓损伤Frankel分级,采用Barthel指数评估2组患者的日常生活能力。结果治疗前2组患者感觉功能及运动功能评分比较差异均无统计学意义(P>0.05),2组患者治疗后1d、1a时感觉功能及运动功能评分显著高于治疗前(P<0.05),治疗后1a时感觉功能及运动功能评分显著高于治疗后1d(P<0.05);治疗后1d、1a,观察组患者感觉功能及运动功能评分显著高于对照组(P<0.05)。治疗后1d、1a,观察组患者脊髓损伤改善率分别为46.2%(13/28)、85.7%(24/28),对照组患者脊髓损伤改善率分别为28.6%(8/28)、64.2%(18/28);2组患者治疗后1a脊髓损伤改善率显著高于治疗后1d(χ^2=9.172、10.748,P<0.05);治疗后1d、1a,观察组患者脊髓损伤改善率显著高于对照组(χ^2=6.461、7.015,P<0.05)。2组患者治疗前生活能力评分比较差异无统计学意义(P>0.05);2组患者治疗后1d、1a时生活能力评分显著高于治疗前(P<0.05),治疗后1a时生活能力评分显著高于治疗后1d(P<0.05);治疗后1d、1a,观察组患者生活能力评分显著高于对照组(P<0.05)。结论mNGF联合康复训练可有效促进ASCI患者神经功能恢复,提高患者生活质量。
Objective To investigate the clinical effect of rat nerve growth factor (mNGF) combined with rehabilitation training in treatment of acute spinal cord injury (ASCI). Methods Fifty-six patients with ASCI who underwent surgical treatment in the Tenth People′s Hospital of Zhengzhou City from February 2013 to December 2016 were selected and divided into observation group and control group according to the post-operative treatment methods,with twenty-eight cases in each group.The patients in the two groups were given routine symptomatic support treatment,while the patients in the control group began rehabilitation training at 15 days after operation on the basis of symptomatic support treatment.On the basis of the treatment in the control group,the patients in the observation group were treated with mNGF 20 μg,intramuscular injection once a day.The patients in the two groups were treated for two courses of treatment (30 days as a course of treatment).Neurological function of the patients was evaluated by the scoring standard of American Spinal Injury Association,and the Frankel classification of spinal cord injury was performed,and the activity of daily living (ADL) of patients in the two groups was assessed by Barthel index. Results There was no significant difference in sensory and motor function scores between the two groups before treatment ( P >0.05).The scores of sensory and motor function at one day and one year after treatment were significantly higher than those before treatment ( P <0.05),and the scores of sensory and motor function at one year after treatment were significantly higher than those at one day after treatment in two groups ( P <0.05).The scores of sensory and motor function in the observation group were significantly higher than those in the control group at one day and one year after treatment ( P <0.05).The improvement rate of spinal cord injury in the observation group was 46.2%(13/28) and 85.7%(24/28) respectively,and that in the control group was 28.6%(8/28) and 64.2%(18/28) respectively at one day and one year after treatment.The improvement rate of spinal cord injury at one year after treatment was significantly higher than that at one day after treatment in the two groups (χ 2=9.172,10.748;P <0.05).The improvement rate of spinal cord injury in the observation group was significantly higher than that in the control group at one day and one year after treatment (χ 2=6.461,7.015;P <0.05).There was no significant difference in the score of ADL between the two groups before treatment ( P >0.05).The scores of ADL at one day and one year after treatment were significantly higher than those before treatment ( P <0.05),and the scores at one year after treatment were significantly higher than those at one day after treatment in the two groups ( P <0.05).The scores of ADL in the observation group were significantly higher than those in the control group at one day and one year after treatment ( P <0.05). Conclusion mNGF combined with rehabilitation training can effectively promote the recovery of neurological function and improve the quality of life in patients with ASCI.
作者
平明亮
宋朝
PING Ming-liang;SONG Chao(Department of Rehabilitation Medicine,the Tenth People′s Hospital of Zhengzhou City,Zhengzhou 450000,Henan Province,China;Department of Rehabilitation Medicine,Zhengzhou Central Hospital,Zhengzhou 450000,Henan Province,China)
出处
《新乡医学院学报》
CAS
2019年第9期847-850,共4页
Journal of Xinxiang Medical University
关键词
急性脊髓损伤
鼠神经生长因子
康复训练
神经功能
acute spinal cord injury
mouse nerve growth factor
rehabilitation training
neurological function
