高压氧联合康复训练治疗脊髓损伤的临床效果回顾性分析

Retrospective Analysis of the Clinical Efficacy of Hyperbaric Oxygen Combined with Rehabilitation Training in the Treatment of Spinal Cord Injury

摘要: 目的：探讨高压氧(Hyperbaric Oxygen, HBO)联合常规康复训练对脊髓损伤(Spinal Cord Injury, SCI)患者神经功能、日常生活活动能力及康复预后的临床疗效，为新疆生产建设兵团地区脊髓损伤患者的康复治疗方案优化提供临床依据。方法：回顾性分析2022年1月~2025年12月期间，于新疆生产建设兵团医院康复医学科住院治疗的84例脊髓损伤患者的完整临床资料。根据治疗方案的不同，将所有患者分为观察组与对照组，每组各42例。对照组患者仅采用常规康复训练方案进行治疗，观察组患者在对照组常规康复训练的基础上，加用高压氧治疗，两组患者均连续治疗3个月。治疗前及治疗3个月后，采用美国脊髓损伤协会(American Spinal Injury Association, ASIA)感觉评分、运动评分及分级标准，评估两组患者的神经功能恢复情况；采用Barthel指数(Barthel Index, BI)、功能独立性评定量表(Functional Independence Measure, FIM)，评估两组患者的日常生活活动能力及功能独立性；同时记录两组患者治疗期间的不良反应发生情况，比较两组的治疗效果及安全性。结果：治疗前，两组患者的性别、年龄、损伤原因、损伤节段、ASIA分级等一般资料比较，差异均无统计学意义(P > 0.05)，具有可比性。治疗3个月后，两组患者的ASIA感觉评分、运动评分、BI评分及FIM评分均较治疗前显著升高，差异有统计学意义(P < 0.05)；且观察组上述各项评分的升高幅度均显著大于对照组，差异有统计学意义(P < 0.05)。观察组患者ASIA分级改善总有效率为85.71%，显著高于对照组的61.90%，差异有统计学意义(P < 0.05)。治疗期间，观察组共出现5例轻微不良反应，其中耳痛3例、头痛2例，经对症处理后均缓解，无严重不良反应发生；对照组未出现明显不良反应，两组不良反应发生率比较，差异无统计学意义(P > 0.05)。结论：高压氧联合常规康复训练治疗脊髓损伤，能有效改善患者的神经感觉及运动功能，显著提升患者的日常生活活动能力和功能独立性，治疗效果优于单一常规康复训练，且安全性良好，可在新疆生产建设兵团地区临床推广应用，为边疆地区脊髓损伤患者的康复治疗提供更优选择。

Abstract: Objective: To investigate the clinical efficacy of Hyperbaric Oxygen (HBO) combined with conventional rehabilitation training on neurological function, activities of daily living, and rehabilitation outcomes in patients with Spinal Cord Injury (SCI), and to provide a clinical basis for optimizing rehabilitation treatment protocols for SCI patients in the Xinjiang Production and Construction Corps region. Methods: A retrospective analysis was conducted on the complete clinical data of 84 SCI patients hospitalized in the Department of Rehabilitation Medicine, Xinjiang Production and Construction Corps Hospital, from January 2022 to December 2025. Based on different treatment protocols, all patients were divided into an observation group and a control group, with 42 patients in each group. The control group received only conventional rehabilitation training, while the observation group received HBO therapy in addition to the conventional rehabilitation training provided to the control group. Both groups were treated continuously for 3 months. Before treatment and after 3 months of treatment, the American Spinal Injury Association (ASIA) sensory score, motor score, and impairment scale grade were used to assess neurological function recovery. The Barthel Index (BI) and Functional Independence Measure (FIM) were used to evaluate activities of daily living and functional independence. Adverse reactions during treatment were recorded, and treatment efficacy and safety were compared between the two groups. Results: Before treatment, there were no statistically significant differences (P > 0.05) in general characteristics such as gender, age, cause of injury, injury level, and ASIA grade between the two groups, indicating comparability. After 3 months of treatment, ASIA sensory scores, motor scores, BI scores, and FIM scores in both groups were significantly higher than before treatment, with a statistically significant difference (P < 0.05). Furthermore, the magnitude of improvement in all the above scores was significantly greater in the observation group than in the control group, with a statistically significant difference (P < 0.05). The total effective rate of ASIA grade improvement in the observation group was 85.71%, significantly higher than the 61.90% in the control group (P < 0.05). During treatment, 5 mild adverse reactions occurred in the observation group (3 cases of ear pain and 2 cases of headache), all of which resolved after symptomatic treatment, with no severe adverse reactions. No significant adverse reactions occurred in the control group. There was no statistically significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion: Hyperbaric oxygen combined with conventional rehabilitation training for SCI can effectively improve patients’ neurological sensory and motor functions, significantly enhance activities of daily living and functional independence. Its therapeutic effect is superior to conventional rehabilitation training alone, with good safety. It is worthy of clinical promotion and application in the Xinjiang Production and Construction Corps region, providing a better option for the rehabilitation treatment of SCI patients in frontier areas.