目的：探讨下肢康复机器人联合康复训练对神经外科脊髓损伤截瘫患者膀胱尿道功能、平衡能力及 步行功能的影响。方法：选取 2022 年 12 月—2023 年 12 月于首都医科大学附属北京康复医院收治的脊髓损伤截瘫 患者 100 例作为研究对象，以随机数字表法分为对照组（n=50，采用康复训练）与观察组（n=50，采用下肢康复机 器人联合康复训练），比较两组患者膀胱尿道功能（膀胱容量、残余尿量、最大排尿量），尿动力学指标 [ 逼尿肌 压（Pdet）、膀胱顺应性（BC）、膀胱压（Pves）]，平衡功能 [Berg 平衡量表（BBS）]，下肢运动功能 [ 简化的下 肢 Fugl-Meyer 运动功能量表（FMA-LE）]，步行功能 [ 功能性步行分级（FAC）]。结果：训练前，两组患者膀胱尿 道功能对比，差异无统计学意义（P>0.05）；训练后，两组患者较训练前均有改善，且观察组膀胱容量、最大排尿 量比对照组多，残余尿量比对照组少，差异有统计学意义（P<0.05）。训练前，两组患者尿动力学指标对比，差异 无统计学意义（P>0.05）；训练后，两组患者较训练前均改善，且观察组患者 Pdet、Pves 比对照组低，BC 比对照组高， 差异有统计学意义（P<0.05）。训练前，两组患者 BBS、FMA-LE 评分对比，差异无统计学意义（P>0.05）；训练后， 两组患者较训练前均提高，且观察组患者评分比对照组高，差异有统计学意义（P<0.05）。训练前，两组患者 FAC 分级情况对比，差异无统计学意义（P>0.05）；训练后，观察组患者分级情况比对照组优，差异有统计学意义（P<0.05）。 结论：对神经外科脊髓损伤截瘫患者采用下肢康复机器人联合康复训练方案，更能改善患者的膀胱尿道功能，提高 平衡能力与步行功能。

Objective: To explore the effect of lower limb rehabilitation robot combined with rehabilitation training on bladder urethral function, balance and walking function in spinal cord injury-induced paraplegic patients. Methods: 100 spinal cord injury-induced paraplegic patients who admitted to Beijing Rehabilitation Hospital Affiliated to Capital Medical University from December 2022 to December 2023 were selected as the research subjects. They were randomly divided into the control group and observation group using a random number table, with 50 cases in each group. The control group received rehabilitation training, while the observation group were treated with lower limb rehabilitation robot combined with rehabilitation training. The bladder urethral function (bladder volume, residual urine volume, maximum urination volume), urodynamic indicators such asd detrusor pressure (Pdet), bladder compliance (BC), bladder pressure (Pves), Berg balance scale (BBS), Fugl-Meyer assessment of lower extremity (FMA-LE), and functional ambulation category (FAC) were compared between the two groups. Results: Before training, there was no statistically significant difference in bladder urethral function between the two groups (P>0.05). After training, bladder urethral function of the two groups was both improved compared with that before training, but the bladder volume and maximum urination volume in the observation group were higher than those in the control group, while the residual urine output in the observation group was less than that in the control group, and the differences were statistically significant (P<0.05). Before training, there was no statistically significant difference in urodynamic indicators between the two groups (P>0.05). After training, urodynamic indicators of the two groups were both improved compared with those before training, and the observation group had lower Pdet and Pves than the control group, while the BC was higher in the observation group than that in the control group, with statistical significance (P<0.05). Before training, there was no statistically significant difference in BBS and FMA scores between the two groups (P>0.05). After training, BBS and FMA scores in the two groups were both improved compared with those before training, and they were higher in the observation group than those in the control group, and the differences were statistically significant (P<0.05). Before training, there was no statistically significant difference in FAC grading between the two groups (P>0.05). After training, the FAC grading in the observation group was better than that in the control group, and the difference was statistically significant (P<0.05). Conclusion: Application of lower limb rehabilitation robot combined rehabilitation training in spinal cord injury-induced paraplegic patients can better improve their bladder and urethral function, balance ability, and walking function.

收稿日期：2024-05-22  录用日期：2024-06-27 

Received Date: 2024-05-22  Accepted Date: 2024-06-27 

基金项目：国家重点研发计划课题任务书（2020YFC2004303） 

Foundation Item: National Key R & D Plan Project(2020YFC2004303) 

通讯作者：杨杰，Email：fmj198912028@163.com 

Corresponding Author: YANG Jie, Email: fmj198912028@163.com 

引用格式：杨杰，王凤双，潘化杰 . 下肢康复机器人联合康复训练对脊髓损伤截瘫患者的影响 [J]. 机器人外科学杂志（中英文）， 2024，5（6）：1094-1099. 

Citation: YANG J, WANG F S, PAN H J. Effect of lower limb rehabilitation robot combined with rehabilitation training on spinal cord injury-induced paraplegic patients[J]. Chinese Journal of Robotic Surgery,  2024, 5(6): 1094-1099.

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