蜡疗配合作业疗法对小儿臂丛神经损伤患儿的治疗研究

摘要

目的 探讨蜡疗配合作业疗法对小儿臂丛神经损伤患儿的治疗研究.方法 选择收治的臂丛神经损伤患儿82例,按照随机表法分为观察组与对照组,每组41例.2组患儿均于入院后用低频脉冲疗法协调患侧上肢肌力,采用生物刺激反馈修复患肢的受损神经.对照组采用作业疗法,观察组在对照组基础上结合蜡疗治疗.2组均以1个月为1个疗程,间隔1周,再进行下1个疗程,连续5个疗程.比较2组疗效、三角肌肌力修复时间和肱二头肌肌力改善时间,及治疗前后正中神经和腋神经传导速度.结果 观察组治疗总有效率为97.56%高于对照组的79.05% (P<0.05);观察组三角肌肌力修复时间和肱二头肌肌力改善时间快于对照组(P<0.05);2组治疗后正中神经和腋神经传导速度增加(P<0.05);观察组治疗后正中神经和腋神经传导速度高于对照组(P<0.05);2组治疗前Modified Mallet classification分数比较差异无统计学意义(P>0.05);2组治疗后 Modified Mallet classification分数增加(P<0.05);观察组治疗后Modified Mallet classification分数高于对照组(P<0.05).结论 蜡疗配合作业疗法对小儿臂丛神经损伤患儿疗效明显,具有重要研究意义.%Objective To investigate the therapeutic effects of keritherapy combined with occupational therapy on brachial plexus injury in children.Methods Eighty-two children patients with brachial plexus injuries who were treated in our hospital from January 2015 to January 2017 were randomly divided into observation group (n=41) and control group (n=41).The patients in both groups were treated by low frequency pulse therapy to coordinate the upper limb muscle strength after admission,and biological feedback was used to repair the damaged nerve of affected limb. Moreover the patients in control group were treated by occupational therapy,however,the patients in observation group,on the basis of control group,were treated by keritherapy,with a treatment course of one month,at 1-week interval, total five treatment courses for both groups. The curative effects,the recovery time of deltoid muscle strength and the improvement time of biceps brachii muscle strength were observed and compared between two groups. Moreover the conduction velocities of median nerve and axillary nerve before and after treatment were observed and compared between two groups.Results The total effective rate in observation group was 97.56%,which was significantly higher than that (79.05%) in control group (P<0.05),and the recovery time of deltoid muscle strength and the improvement time of biceps brachii muscle strength in observation group were faster than those in control group (P <0.05). The conduction velocities of median nerve and axillary nerve after treatment were significantly increased in both groups (P <0.05),moreover,which in observation group were significantly higher than those in control group(P<0.05). In addition before treatment there were no significant differences in Modified Mallet classification scores between two groups (P>0.05),however,after treatment Modified Mallet classification scores were significantly increased in both groups, moreover,which in observation group were significantly higher than those in control group (P < 0. 05). Conclusion The keritherapy combined with occupational therapy has obvious curative effects on brachial plexus injury in children.