ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2019, Vol. 11 ›› Issue (4): 343-347.doi: 10.3969/j.issn.1674-3865.2019.04.018

• 临床研究 • 上一篇    下一篇

早期针刺促醒配合综合康复干预重度颅脑外伤患儿临床疗效观察

何金华，袁丽平，覃蓉，刘华，周洪涛   

  1. 410007 长沙，湖南省儿童医院康复科
  • 出版日期:2019-08-25 发布日期:2019-09-18
  • 通讯作者: 覃蓉，E-mail：13808486876@139.com
  • 作者简介:何金华（1973-），女，医学硕士，副主任医师。研究方向：儿童神经系统疾病的康复

Clinical effect of early acupuncture to promote awakening combined with comprehensive rehabilitation on children with severe craniocerebral trauma

HE Jinhua，YUAN Liping，QIN Rong,LIU Hua，ZHOU Hongtao   

  1. Rehabiltation Department of Hunan Children's Hospital， Changsha 410007， China
  • Online:2019-08-25 Published:2019-09-18

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摘要：
目的
观察早期针刺促醒治疗配合综合康复介入干预重度颅脑外伤患儿的临床疗效影响。
方法
选取2013年1月至2018年8月我院诊治的重症颅脑损伤患儿48例，按早期是否针刺促醒治疗进行分组，早期介入针灸及综合康复治疗为观察组（n=28），早期介入综合康复治疗，未予针灸治疗为对照组（n=20）。治疗3个月比较两组患儿意识障碍程度、意识障碍恢复情况、日常生活能力评定及临床疗效。
结果
观察组患儿治疗1、2、3个月后格拉斯哥昏迷评分量表（GCS）评分均显著高于对照组，差异有统计学意义（P<0.05)。两组重复测量方差分析结果显示，时间效应与交互效应比较差异均有统计学意义（P<0.05)，表明两组患儿的GCS评分总体呈现上升趋势，且观察时点的选择可能与两组GCS评分差异显著与否存在关联。治疗3个月观察组意识清醒率显著高于对照组，意识障碍持续时间显著短于对照组，差异有统计学意义（P<0.05)；观察组3岁以上日常生活能力Barthel指数显著高于对照组，差异有统计学意义（P<0.05）。治疗3个月时观察组临床总有效率为89.2%（25/28），显著高于对照组65.0%（13/20），差异有统计学意义（P<0.05)。
结论
早期介入针灸促醒配合综合康复治疗能明显缩短重度颅脑外伤意识障碍时间，促进重度颅脑外伤日常生活能力改善，提高认知及运动能力恢复。

关键词: 重度颅脑外伤, 针灸, 早期康复, 临床疗效, 儿童

Abstract:
Objective
To observe the clinical effect of early acupuncture to promote awakening combined with comprehensive rehabilitation intervention on children with severe craniocerebral trauma.
Methods
nTotally 48 children with severe craniocerebral injury who were treated from January 2013 to August 2018 in our hospital were chosen. They were divided into two groups according to whether or not early acupuncture was used to promote awakening. The observation group was treated with early interventional acupuncture and comprehensive rehabilitation(n=28), while the control group only received comprehensive rehabilitation and was not treated with acupuncture and moxibustion(n=20). After 3 months of treatment, the rate of disturbance of consciousness， recovery of disturbance of consciousness， clinical efficacy and daily living ability of children were compared between the two groups.
Results
The GCS scores of the observation group were significantly higher than those of control group at 1 month,2 months and 3 months after treatment, respectively, and the difference was statistically significant(P<0.05). The repeated measurement variance analysis showed that there was statistical difference in the time effect and interaction effect(P<0.05),indicating that GCS scores of the two groups had an upward tendency, and the significance of difference in GCS scores between the two groups might be related to the time point of observation(P<0.05).After 3 months of treatment, the rate of conscious awareness of observation group was significantly higher than that of the control group, while the duration of disturbance of consciousness was significantly shorter, and there was statistical difference(P<0.05). The Barthel index in daily living ability of children over 3 years old in observation group was significantly higher than that in control group(P<0.05). At 3 months after treatment, the clinical total effective rate of observation group was 89.2%(25/28), significantly higher than the control group(65.0%,13/20)(P<0.05).
Conclusion
Early acupuncture to promote awakening combined with comprehensive rehabilitation therapy can significantly shorten the time of consciousness disturbance of severe craniocerebral trauma， promote the improvement of daily living ability of severe craniocerebral trauma， and improve the recovery of cognition and motor abilities.

Key words: Severe craniocerebral injury, Acupuncture, Early rehabilitation, Clinical curative effect, Children