脊髓电刺激对脊髓损伤治疗的研究进展
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山西白求恩医院

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Research progress in the treatment of spinal cord injury by spinal cord electrical stimulation
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1.Shanxi 2.Bethune 3.Hospital;4.Shanxi&5.amp;6.#160;7.Bethune&8.Shanxi Bethune Hospital

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    摘要:

    脊髓损伤的发病率逐年上升,其造成的一系列功能神经障碍及高额的护理费用可对脊髓损伤患者的生活质量及身心健康造成严重的影响。现阶段随着对脊髓损伤后的细胞、分子机制及组织学事件有了深入研究,我们对脊髓损伤的机制有了充分的认知,但脊髓损伤后的一系列并发症仍未得到完全的改善,患者迫切需要更安全、更有效的方式来进一步促进损伤后的功能恢复。目前神经调控技术已被广泛应用于一线临床工作中,其中脊髓电刺刺激在脊髓损伤的多领域取得了重大的突破:在脊髓损伤后的疼痛管理方面提出了高频电刺激等多种新兴刺激模式,使镇痛作用更有效、更持久;在运动功能重建方面,能使完全脊髓损伤后的截瘫患者恢复较为复杂的运动功能;在括约肌功能的恢复领域也可明显缓解了神经源性膀胱、神经源性肠道功能障碍引起的大小便功能障碍。就此,本文通过对脊髓电刺激在脊髓损伤后的疼痛、运动感觉功能障碍、括约肌功能障碍3个方面的研究现状及脊髓电刺激在功能重建方面可能存在的机制进行综述,进而探讨了脊髓电刺激在脊髓损伤领域中的广泛应用前景,分析了目前脊髓电刺激研究的不足之处,进而对脊髓电刺激技术的未来发展方向提出简单的设想,期望在将来的临床工作及临床研究中有指导作用。

    Abstract:

    The incidence rate of spinal cord injury(SCI) is increasing year by year. A series of functional neurological disorders and high nursing costs caused by SCI can seriously affect the quality of life and physical and mental health of patients with SCI. At present, with in-depth research on the cellular, molecular mechanisms, and histological events after SCI, we have gained a full understanding of the mechanism of SCI. However, a series of complications after SCI have not been completely improved, and patients urgently need safer and more effective ways to further promote functional recovery after injury.Spinal cord electrical stimulation(SCS) was first applied to pain management after SCI. By adjusting the parameters of a programmable controller, it can effectively cover various types of pain after SCI. It is a major treatment measure used to alleviate chronic pain. Currently, emerging stimulation modes such as high-frequency stimulation have been widely used in clinical work, achieving more effective analgesic effects for the treatment of chronic pain by SCS; In addition to research on pain management, SCS can also improve motor function after SCI, even in the most challenging area of SCI, which is complete SCI, it can promote the reconstruction of motor function; In addition, neurogenic bladder and neurogenic intestinal dysfunction are the most common complications after SCI, which can have a serious impact on the quality of life of patients. SCS can also effectively improve the function of the patient's sphincter and promote improvement in bowel and bowel function. As a safe and effective treatment measure, SCS has been applied in frontline clinical work and has achieved remarkable results in the field of SCI. However, there is still no definite conclusion on the application of SCS in patients with high-level SCI and its mechanism of promoting functional recovery. Therefore, it is necessary to review previous relevant literature research. Through the review of the above relevant literature, I hope to provide new ideas for further research on SCS, which can provide certain guiding significance for future clinical work.

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  • 收稿日期:2023-12-02
  • 最后修改日期:2024-02-07
  • 录用日期:2024-02-18
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