中药熏洗疗法对断指再植术后患指屈曲功能的影响

目的:观察断指再植术后患指屈曲功能的恢复情况。方法:于2002年12月至2005年12月间,对我院骨外科断指再植成功的56例(71指)均于术中关闭伤口前将几丁糖注射液注射到鞘管内及喷涂于肌腱缝合口周围,术后进行早期功能锻炼。其中我们选取30例(39指)作为治疗组,在术后3周开始运用骨洗方(我院协定中药外用方)对患指进行中药外用熏洗治疗,连续使用4周;另外26例(32指)患者未使用中药熏洗,其余治疗过程相同,以作为对照组。两组均于术后6个月获得随访,并参照中华医学会手外科学会手部肌腱修复后评定标准,按手指总主动活动度(TAM)法,对患指屈曲功能进行疗效评估。结果:治疗组及对照组共56例患者均获得半年以上随访,随访率100%。治疗组39指,疗效优良者34指,优良率为87.2%;对照组32指,疗效优良者21指,优良率为65.6%。统计学显示两组间差异有显著性意义(P<0.05)。结论:运用中药熏洗疗法(骨洗方)可明显改善断指再植术后患指的屈曲活动功能,显著促进手功能的康复。

Effects of Traditional Chinese Medicine Fumigation and Wash Therapy on Flection Function of Amputated Finger after Replantation Surgery

Objectives:To evaluate the effects of traditional Chinese medicine fumigation and wash therapy on flection function of amputated fingers after replanlation surgery.Methods:From Dec.2002 to Dec.2005, we have successfully replanted 71 amputated fingers in 56 cases.All cases were used by medical chitosan to injected into the sheathing canal or to spray painting near the tendon suture position and were performed early functional exercise.Among these cases,we selected 30 cases(39 fingers) as the Chinese medicine treatment group and used the bone-wash formula(developed by our hospital) to fumigate and wash the replanted finger just 3 weeks after surgery The fumigation and wash therapy were continued using for 4 weeks.The other 26 cases(32 fingers),as the controlled groups were use a by the same treating strategy except the Chinese medicine fumigate and wash therapy.Both groups were all followed up 6 months after surgery and evaluated the flection function of the finger by the TAM methods based on the measuring standard of hand surgery association of Chinese medical association.Results:All cases were successfully followed up in both groups.In the Chinese medicine treating group,totally 33 finger get the effects of excellent and good while just 21 fingers get the effects of excellent and good in the controlled groups.The difference of treating effects of both groups is statistically significant.Conclusion: Traditional Chinese medicine fumigation and wash therapy can significantly improved the flection function of amputated fingers after replantation surgery and promoted the hand functional rehabilitation.