CAJ | 학술논문

目的探讨个体化、量化康复训练对屈指肌腱吻合术后功能恢复的影响.方法将180例屈指肌腱吻合术患者随机分为量化组及对照组.量化组患者在术中测量所吻合肌腱的最大抗张强度(F max),术中安装训练支具,测量吻合术后肌腱两断端分离达到2 mm间隙时的橡皮筋长度及载荷,并加装保护装置,术后给予个体化、量化康复训练.对照组患者术中未进行肌腱最大抗张强度测定,术后康复训练时亦无特殊保护装置,由患者自行训练手指活动功能.为进一步研究康复训练频率对疗效的影响,将量化组及对照组分别细分为A,B两亚组,分别给予每天3次(A组)、每天6次(B组)康复训练.结果经3个月训练后,发现量化组术后无肌腱断离者,对照组有6例患者发生肌腱再断离,量化组优良率达91.1%,对照组优良率为80.0%,组间差异具有统计学意义(P<0.05);进一步分析发现,量化B组患者康复疗效明显优于其它亚组,组间差异均有统计学意义(P<0.05).结论个体化、量化康复训练能有效防止肌腱吻合术后患者肌腱再断离,且每天训练6次可能是较佳康复治疗频率.
목적 탐토개체화、양화강복훈련대굴지기건문합술후공능회복적영향.방법 장180례굴지기건문합술환자수궤분위양화조급대조조.양화조환자재술중측량소문합기건적최대항장강도(F max),술중안장훈련지구,측량문합술후기건량단단분리체도2 mm간극시적상피근장도급재하,병가장보호장치,술후급여개체화、양화강복훈련.대조조환자술중미진행기건최대항장강도측정,술후강복훈련시역무특수보호장치,유환자자행훈련수지활동공능.위진일보연구강복훈련빈솔대료효적영향,장양화조급대조조분별세분위A,B량아조,분별급여매천3차(A조)、매천6차(B조)강복훈련.결과 경3개월훈련후,발현양화조술후무기건단리자,대조조유6례환자발생기건재단리,양화조우량솔체91.1%,대조조우량솔위80.0%,조간차이구유통계학의의(P<0.05);진일보분석발현,양화B조환자강복료효명현우우기타아조,조간차이균유통계학의의(P<0.05).결론 개체화、양화강복훈련능유효방지기건문합술후환자기건재단리,차매천훈련6차가능시교가강복치료빈솔.
Objective To evaluate the effect of individualized and quantified rehabilitation exercise after te-nosuture of the digital flexor tendon. Methods One hundred and eighty cases of digital flexor tendon tenosuture were randomly divided into a quantification group and a control group. For the quantification group, the maximal ten-sile strength against rupture (Fmax) was measured during the operation. After splinting, the length of an elastic bandwas measured when there was a 2 mm clearance between the 2 ends of the sutured tendon, and the protective device was then fixed with all its parameters unchanged in the whole study. For the control group, Fmax was not measured and there was no protective device during training. Both groups were subdivided into subgroups A and B according to the daily training frequency. Training frequencies of 3 or 6 times per day were applied to the two subgroups. Results After 3 months of rehabilitation treatment, there was no re-rupture in the quantification group, but 6 cases of re-rup-ture occurred in the control group. 91% of the eases in the quantification group were evaluated as excellent or good, while in the control group 80% of the cases were evaluated as excellent or good. Clinical efficacy was significantly better in the quantification subgroup receiving 6 treatments per day than in any other subgroup. Conclusions Indi-vidualized and quantified rehabilitation exercise can prevent tendon re-rupture after tenosuture. 6 sessions of training per day may be better than 3 sessions per day.