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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。
Objective To establish and implement the clinical pathway of occupational chronic n-hexane poisoning and evaluate its effect. Methods A total of 24 patients with chronic n-hexane poisoning were enrolled in the study. Based on the nutritional nerves and the improvement of circulating drug therapy, the patients were mainly treated with medical training (MTT), combined with low-frequency pulse, computer IF therapy, Acupuncture therapy, hand drafting and massage and other means of comprehensive rehabilitation, while setting the MTT is not implemented, the other 50 cases of the same rehabilitation treatment for the control group were evaluated before treatment, after 6 weeks, 3 months after treatment (VAS dynamic score), skin and limb sensation, muscle circumference and major joint muscle strength, standing balance ability, lower extremity function status and daily living ability (ADL score) after 6 months, The therapeutic effects of the two groups at the same time after treatment were compared. Results 1) Before the treatment, there were different degrees of triceps pain, distal skin sensation and muscular atrophy, limited or obstructive motor function of lower extremities, and decreased ADL. 2) After 6 weeks of treatment respectively, there was no significant difference between the two groups in evaluation index and before treatment (P> 0.05). 3) After treatment for 3 months and 6 months, the above indexes in two groups of patients were significantly different from those before treatment (P <0.05); the above evaluation indexes in the observation group were significantly lower than those in the control group after 3 months and 6 months The difference was statistically significant (P <0.05). Conclusion The establishment and implementation of MTT-based rehabilitation of clinical pathways, the effect of occupational chronic n-hexane poisoning significant effect, worthy of clinical promotion.