持续被动活动在烧伤爪形手术后康复中的应用研究
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摘要
目的探讨持续被动活动(Continues passive motion,CPM)在烧伤爪形手整形术后康复中的应用效果。方法回顾分析2017年1月至2018年12月收治的28例(41只手)烧伤爪形手患者的临床资料,分为观察组和对照组,对照组进行常规康复治疗,观察组在常规康复治疗基础上增加CPM训练。比较两组第2～5指的掌指关节的主动活动度(Active range of motion,AROM)、被动活动度(Passive range of motion,PROM)以及疼痛视觉模拟评分(Visual analogue scale,VAS)在康复治疗前后的变化。结果康复治疗后两组AROM、PROM都有明显改善,VAS明显降低(P<0.05);组间比较显示,第2、4、8周时,观察组比对照组AROM、PROM提高更为显著,VAS降低更加明显(P<0.05)。结论 CPM能够明显减少烧伤爪形手常规康复治疗中产生的疼痛,提高患者的依从性,加快术后康复进程,取得更好的康复效果。
Objective To investigate the application efficacy of continues passive motion(CPM) in rehabilitation for postoperative claw hands after burns. Methods Clinical records of 28 cases(41 hands) with claw hands were retrospectively analyzed from January 2017 to December 2018. All the patients were divided into observation group and control group.Patients in control group were given conventional rehabilitation therapy, while patients in observation group were given CPM on the basis of conventional rehabilitation therapy. VAS, AROM and PROM of 2 nd-5 th metacarpophalangeal joint were compared in the two groups before and after treatment. Results After treatment, significant increment in AROM, PROM and significant reduction in VAS(P<0.05) were observed in the two groups. AROM, PROM in observation group were higher than those in control group at each time point(2 w, 4 w, 8 w), while VAS in observation group was much lower than that in control group(P <0.05). Conclusion CPM can significantly reduce the pain during conventional rehabilitation therapy,improve patient compliance, accelerate the rehabilitation process, and achieve better results.
Objective To investigate the application efficacy of continues passive motion(CPM) in rehabilitation for postoperative claw hands after burns. Methods Clinical records of 28 cases(41 hands) with claw hands were retrospectively analyzed from January 2017 to December 2018. All the patients were divided into observation group and control group.Patients in control group were given conventional rehabilitation therapy, while patients in observation group were given CPM on the basis of conventional rehabilitation therapy. VAS, AROM and PROM of 2 nd-5 th metacarpophalangeal joint were compared in the two groups before and after treatment. Results After treatment, significant increment in AROM, PROM and significant reduction in VAS(P<0.05) were observed in the two groups. AROM, PROM in observation group were higher than those in control group at each time point(2 w, 4 w, 8 w), while VAS in observation group was much lower than that in control group(P <0.05). Conclusion CPM can significantly reduce the pain during conventional rehabilitation therapy,improve patient compliance, accelerate the rehabilitation process, and achieve better results.
引文
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[10]张志杰,刘春龙,王俊,等.持续被动活动结合康复治疗预防及改善深度烧伤后肘关节屈曲功能障碍的临床研究[J].中国康复医学杂志,2008,23(5):432-433.
[2]王伊宁,齐鸿燕.网状脱细胞异体真皮基质联合自体刃厚皮片复合移植修复小儿爪形手[J].中华整形外科杂志,2017,33(3):187-190.
[3] Brown M, Chung KC. Postburn Contractures of the Hand[J].Hand Clin,2017,33(2):317-331.
[4]刘媛媛,李养群.物理治疗促进伤口愈合及预防瘢痕形成在整形外科的应用[J].医学综述,2013,19(5):877-881.
[5]金荣,解海霞,刘艳,等.烧伤后瘢痕瘙痒患者的护理干预[J].护理学杂志,2015,30(2):38-39.
[6]洪宝顺,卢才教.低温冷敷防治烧伤早期增生性瘢痕[J].中国临床康复,2004,8(17):3344.
[7] Costa AMA, Peyrol S, Porto LC, et al. Mechanical forces induce scar remodeling:study in non-pressure-treated versus, pressuretreated hypertrophic scars[J]. Am J Pathol,1999,155(5):1671-1679.
[8]李瑾怡.基于音乐干预的烧伤患者功能锻炼中疼痛管理策略研究[D].重庆:第三军医大学,2017.
[9]路琳,庹晓晔.应用CPM对手部烧伤植皮术后关节疼痛的疗效观察[J].中国民康医学,2008,20(12):1299.
[10]张志杰,刘春龙,王俊,等.持续被动活动结合康复治疗预防及改善深度烧伤后肘关节屈曲功能障碍的临床研究[J].中国康复医学杂志,2008,23(5):432-433.