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目的探讨高压氧治疗职业性手臂振动病(hand-arm vibration disease,HAVD)的临床疗效和安全性。方法 2010年1月至2013年8月,选择108例职业性手臂振动病患者,随机分为高压氧综合治疗组(HBO组)和常规中西医治疗组(对照组),对照组予改善循环、营养神经、针灸、理疗等中西医综合治疗,HBO组在常规中西医治疗基础上同时进行高压氧治疗。治疗结束后比较两组患者的临床资料、神经肌电图、冷水复温试验指标及不良反应情况。结果两组治疗后的症状和体征均有改善。HBO组治疗手麻症状、痛觉减退、触觉减退、振动觉减退的总有效率优于对照组,差异均有统计学意义(P<0.05)。HBO组正中神经、尺神经的运动传导速度、运动远端潜伏期、感觉传导速度改善情况均优于对照组,差异均有统计学意义(P<0.05)。HBO组左、右手的5 min、10 min复温试验总有效率优于对照组,差异均有统计学意义(P<0.05)。结论HBO联合中西医治疗职业性HAVD疗效显著,能改善患者临床症状、体征、冷水复温率、神经肌电图,且较为安全,值得推广应用。
Objective To investigate the clinical efficacy and safety of hyperbaric oxygen in the treatment of occupational hand-arm vibration disease (HAVD). Methods From January 2010 to August 2013, 108 patients with OSA were randomly divided into hyperbaric oxygen therapy group (HBO group) and conventional Chinese and Western medicine treatment group (control group), the control group was given to improve circulation, Nutrition, nerve, acupuncture, physiotherapy and other integrated traditional Chinese and Western medicine, HBO group in the conventional Chinese and Western medicine based on the same time hyperbaric oxygen therapy. After treatment, the clinical data, neuro EMG, cold water rewarming test indicators and adverse reactions were compared between the two groups. Results Both groups improved symptoms and signs after treatment. The total effective rate of HBO group in treatment of symptoms of marijuana, hypoallergenicity, hypothyroidism and vibratiation was better than that of the control group, with statistical significance (P <0.05). The motor conduction velocity, distance distal movement and sensory conduction velocity of the median nerve and ulnar nerve in HBO group were better than those in the control group, with statistical significance (P <0.05). The total effective rate of 5 min and 10 min rewarming test in HBO group was better than that in control group (P <0.05). Conclusion HBO combined with Western medicine treatment of occupational HAVD significant effect, can improve the clinical symptoms, signs, cold water rate, neuromuscular electrogram, and more safer and worthy of promotion.