手部多功能支具联合弹力手套在手部烧烫伤术后的康复治疗

目的探讨手部多功能支具联合弹力手套在手部烧烫伤术后康复中的临床疗效。方法2017年6月-2018年6月对手部烧烫伤术后住院治疗的40例患者,按1∶1的比例,随机分为观察组和对照组,分别予手部多功能支具联合弹力手套治疗和弹力手套治疗。于术后第3周(治疗前)、康复治疗12周后分别观察记录两组的明尼苏达手灵巧度测试(MMDT)、普渡钉板测验(PPBT)、疼痛程度评分(VAS),并在末次随访时,对手功能恢复情况进行总主动活动度(TAM)评定。结果两组均获得8~16周随访。治疗前两组基本资料及各观察指标比较,差异均无统计学意义(P>0.05)。治疗12周后,两组MMDT、PPBT、VAS评分均有明显改善,差异有统计学意义(P <0.05);组间比较显示,观察组的MMDT、PPBT、VAS评分改善均较对照组显著,差异均有统计学意义(P <0.05);末次随访时,观察组和对照组TAM评定优良率分别为95%和65%,差异有统计学意义(P <0.05)。结论手部多功能支具联合弹力手套治疗方案能有效预防手部烧烫伤术后软组织粘连、瘢痕增生及挛缩的发生,对术后恢复手部功能安全有效,值得临床推广应用。

Rehabilitation treatment of hand-based multi-functional brace combined with elastic gloves in hand burns

Objective To analyze the clinical effect of hand multi-functional brace combined with elastic gloves on the rehabilitation of hand burns.Methods Forty patients who were hospitalized in the emergency hand burns of Foshan Traditional Chinese Medicine Hospital from June 1,2017 to June 1,2018,were randomly divided into the experimental group and the control group according to the ratio of 1:1.Patients in the experimental group were treated with hand multi-functional brace combined with elastic gloves,and the control group was treated with elastic gloves.Minnesota hand dexterity test(MMDT),Purdue nail test(PPBT),pain degree score(VAS)were recorded in the two groups after the third week(before treatment)and after 12 weeks of rehabilitation.At the last follow-up,the opponent's functional recovery was assessed by Total Active Activity(TAM).Results Both groups were successfully followed up for 8 to 16 weeks.There were no significant differences in the basic data and the observation indexes between the two groups before treatment(P>0.05).After 12 weeks of treatment,the MMDT,PPBT,and VAS scores of the two groups were significantly improved,and the difference was statistically significant(P<0.05).The comparison between groups showed that the improvement of MMDT,PPBT and VAS scores in the experimental group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).At the last follow-up, the excellent and good rates of TAM in the experimental group and the control group were 95% and 65%, respectively, and the difference was statistically significant (P <0.05). Conclusion The hand multi-functional brace combined with elastic gloves treatment can effectively prevent the soft tissue adhesion, scar hyperplasia and contracture after hand burns, and it is safe and effective for the recovery of hand function after operation. It is worthy of clinical application.