高杰, 司徒洁, 周宇燕, 胡波, 陈胜雄, 刘文荣, 刘琪. 职业性慢性正己烷中毒康复治疗临床路径构建与评价[J]. 职业卫生与应急救援, 2015, 33(4): 246-251. DOI: 10.16369/j.oher.issn.1007-1326.2015.04.006
引用本文: 高杰, 司徒洁, 周宇燕, 胡波, 陈胜雄, 刘文荣, 刘琪. 职业性慢性正己烷中毒康复治疗临床路径构建与评价[J]. 职业卫生与应急救援, 2015, 33(4): 246-251. DOI: 10.16369/j.oher.issn.1007-1326.2015.04.006
GAO Jie, SITU Jie, ZHOU Yuyan, HU Bo, CHEN Shengxiong, LIU Wenrong, LIU Qi. Medical training therapy plays important role in clinic rehabilitation of occupational chronic n-hexane poisoning patients[J]. Occupational Health and Emergency Rescue, 2015, 33(4): 246-251. DOI: 10.16369/j.oher.issn.1007-1326.2015.04.006
Citation: GAO Jie, SITU Jie, ZHOU Yuyan, HU Bo, CHEN Shengxiong, LIU Wenrong, LIU Qi. Medical training therapy plays important role in clinic rehabilitation of occupational chronic n-hexane poisoning patients[J]. Occupational Health and Emergency Rescue, 2015, 33(4): 246-251. DOI: 10.16369/j.oher.issn.1007-1326.2015.04.006

职业性慢性正己烷中毒康复治疗临床路径构建与评价

Medical training therapy plays important role in clinic rehabilitation of occupational chronic n-hexane poisoning patients

  • 摘要: 目的 建立、实施职业性慢性正己烷中毒康复治疗的临床路径并评价其效果。 方法 设定24例职业性慢性正己烷中毒患者为观察组,在营养神经及改善循环药物治疗的基础上,对其施行以医学训练疗法(MTT)为主,结合低频脉冲、电脑中频理疗、电针疗法、手法牵伸及推拿等手段的综合康复治疗,同时设定未实施MTT,其他康复治疗相同的50例病例为对照组,分别评价两组治疗前、治疗6周后、3个月后及6个月后患者小腿三头肌的疼痛评分(VAS动态评分)、四肢皮肤感觉、肌围度及主要关节肌肉力量、站立平衡能力、下肢功能状况和日常生活能力(ADL评分)等指标,并对两组治疗后相同时间节点的治疗效果指标进行比较。 结果 1)两组病例治疗前存在不同程度的小腿三头肌疼痛,肢体远端皮肤感觉减退及肌肉萎缩,下肢运动功能受限或障碍,ADL下降等症状。2)分别治疗6周后,两组病例上述评价指标与治疗前比较差异无统计学意义(P>0.05)。3)治疗3个月及6个月后两组病例上述指标与治疗前比较,差异有统计学意义(P<0.05);观察组上述评价指标在治疗3个月后、6个月后与对照组比较,差异有统计学意义(P<0.05)。 结论 建立并实施以MTT为主康复治疗临床路径,对职业性慢性正己烷中毒患者的疗效显著,值得临床推广。

     

    Abstract: Objective To evaluate the effectiveness of Medical Training Therapy(MTT)in the clinic rehabilitation of occupational chronic n-Hexane poisoning patients. Methods A total of 24 cases who suffered from occupational chronic n-Hexane poisoning(OCHP)from January 2012 to December 2013, as observed group, were treated with multiple methods including MTT, low frequency impulse electrotherapy, computerized modulated medium frequency therapy, electro-acupuncture, manual stretching and massage. The automatic VAS of triceps surae pain,the reducing distances of numb feeling of limb skin,the circumference and strength of limbs muscle,the standing balance ability,the motor functions of lower limbs and the ADL(activities of daily living) scores were evaluated before and 6 weeks, 3 months, 6 months and 12 months after treatment. These items were compared with those in other 50 poisoning cases who were treated with same way except for MTT from December 2009 to September 2011. Results 1)Two groups of patients had similar symptoms and signs including triceps surae pain, numb feeling on limb skin,amyotrophy, limited or dysfunctional motor functions of lower limbs and the decline of ADL scores before they were treated. 2) After 6-week's treatment, two groups of patients had no obvious improvement(both P>0.05).3)After 3 and 6 months' treatment, the two groups of patients had obvious improvement(both P<0.05), but the MTT treated group improved much better than the other group(both P<0.05). Conclusion MTT with low frequency impulse electrotherapy, computerized modulated medium frequency therapy, electro-acupuncture, manual stretching and massage were very important and effective in the clinic rehabilitation of OCHP.

     

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