中华烧伤杂志
中華燒傷雜誌
중화소상잡지
16
2014年
6期
477-481
,共5页
雷芳%唐有玲%陈佩%罗皓%王娟%谢卫国
雷芳%唐有玲%陳珮%囉皓%王娟%謝衛國
뢰방%당유령%진패%라호%왕연%사위국
烧伤%儿童%手%瘢痕%康复%运动疗法%简易矫形器
燒傷%兒童%手%瘢痕%康複%運動療法%簡易矯形器
소상%인동%수%반흔%강복%운동요법%간역교형기
Burns%Child%Hand%Cicatrix%Rehabilitation%Exercise therapy%Simple orthosis
目的 观察运动疗法联合自制简易矫形器治疗儿童手部烧伤后瘢痕挛缩的疗效.方法 2012年1月-2014年1月,选择在笔者单位康复中心治疗的58例伴单侧手部烧伤患儿,按随机数字表法分为简易矫形器组和常规康复组,每组29例.自创面愈合后,简易矫形器组患儿采取运动疗法配合手部游戏锻炼及佩戴自制简易矫形器(由分指蹼带、自粘弹力绷带、手部输液固定板等组成)治疗,常规康复组患儿行运动疗法配合手部游戏锻炼及佩戴成品压力手套.治疗前及治疗16周后,采用温哥华瘢痕量表评定瘢痕情况,采用Jebsen手功能测试法评定手功能并记录完成测试时间,采用改良Barthel指数评定日常生活活动能力;治疗16周后采用总主动活动度(TAM)法评定关节活动度.对数据行t检验、x2检验. 结果 简易矫形器组患儿瘢痕情况评分治疗前为(12.2±1.3)分,治疗16周后为(6.7±2.2)分,改善分值(5.6±1.8)分;常规康复组患儿瘢痕情况评分治疗前为(12.0±1.4)分,治疗16周后为(7.0±1.8)分,改善分值(5.0±1.0)分.2组患儿瘢痕改善分值差异不明显(t=1.452,P=0.152).简易矫形器组患儿TAM评定优良比75.9％(22/29),常规康复组患儿TAM评定优良比37.9％(11/29),差异明显(t=8.507,P=0.004).简易矫形器组患儿完成手功能测试时间治疗前为(8.2±1.6)min,治疗16周后为(7.1±1.4)min,改善时间为(1.2±1.5)min;常规康复组患儿完成手功能测试时间治疗前为(9.0±1.9)min,治疗16周后为(6.3±1.4) min,改善时间为(2.7±2.7)min.2组患儿手功能测试改善时间差异明显(t=2.618,P=0.012).简易矫形器组患儿日常生活活动能力评分治疗前为(7.7±1.4)分,治疗16周后为(10.4±1.4)分,改善分值为(2.7±1.7)分;常规康复组患儿日常生活活动能力评分治疗前为(7.8±1.4)分,治疗16周后为(9.5±1.4)分,改善分值为(1.7±1.6)分.2组患儿日常生活活动能力改善分值差异明显(t=2.246,P=0.029). 结论 简易矫形器结合运动疗法,有利于烧伤患儿手部功能的恢复及防治手部挛缩畸形,值得推广应用.
目的 觀察運動療法聯閤自製簡易矯形器治療兒童手部燒傷後瘢痕攣縮的療效.方法 2012年1月-2014年1月,選擇在筆者單位康複中心治療的58例伴單側手部燒傷患兒,按隨機數字錶法分為簡易矯形器組和常規康複組,每組29例.自創麵愈閤後,簡易矯形器組患兒採取運動療法配閤手部遊戲鍛煉及珮戴自製簡易矯形器(由分指蹼帶、自粘彈力繃帶、手部輸液固定闆等組成)治療,常規康複組患兒行運動療法配閤手部遊戲鍛煉及珮戴成品壓力手套.治療前及治療16週後,採用溫哥華瘢痕量錶評定瘢痕情況,採用Jebsen手功能測試法評定手功能併記錄完成測試時間,採用改良Barthel指數評定日常生活活動能力;治療16週後採用總主動活動度(TAM)法評定關節活動度.對數據行t檢驗、x2檢驗. 結果 簡易矯形器組患兒瘢痕情況評分治療前為(12.2±1.3)分,治療16週後為(6.7±2.2)分,改善分值(5.6±1.8)分;常規康複組患兒瘢痕情況評分治療前為(12.0±1.4)分,治療16週後為(7.0±1.8)分,改善分值(5.0±1.0)分.2組患兒瘢痕改善分值差異不明顯(t=1.452,P=0.152).簡易矯形器組患兒TAM評定優良比75.9％(22/29),常規康複組患兒TAM評定優良比37.9％(11/29),差異明顯(t=8.507,P=0.004).簡易矯形器組患兒完成手功能測試時間治療前為(8.2±1.6)min,治療16週後為(7.1±1.4)min,改善時間為(1.2±1.5)min;常規康複組患兒完成手功能測試時間治療前為(9.0±1.9)min,治療16週後為(6.3±1.4) min,改善時間為(2.7±2.7)min.2組患兒手功能測試改善時間差異明顯(t=2.618,P=0.012).簡易矯形器組患兒日常生活活動能力評分治療前為(7.7±1.4)分,治療16週後為(10.4±1.4)分,改善分值為(2.7±1.7)分;常規康複組患兒日常生活活動能力評分治療前為(7.8±1.4)分,治療16週後為(9.5±1.4)分,改善分值為(1.7±1.6)分.2組患兒日常生活活動能力改善分值差異明顯(t=2.246,P=0.029). 結論 簡易矯形器結閤運動療法,有利于燒傷患兒手部功能的恢複及防治手部攣縮畸形,值得推廣應用.
목적 관찰운동요법연합자제간역교형기치료인동수부소상후반흔련축적료효.방법 2012년1월-2014년1월,선택재필자단위강복중심치료적58례반단측수부소상환인,안수궤수자표법분위간역교형기조화상규강복조,매조29례.자창면유합후,간역교형기조환인채취운동요법배합수부유희단련급패대자제간역교형기(유분지복대、자점탄력붕대、수부수액고정판등조성)치료,상규강복조환인행운동요법배합수부유희단련급패대성품압력수투.치료전급치료16주후,채용온가화반흔량표평정반흔정황,채용Jebsen수공능측시법평정수공능병기록완성측시시간,채용개량Barthel지수평정일상생활활동능력;치료16주후채용총주동활동도(TAM)법평정관절활동도.대수거행t검험、x2검험. 결과 간역교형기조환인반흔정황평분치료전위(12.2±1.3)분,치료16주후위(6.7±2.2)분,개선분치(5.6±1.8)분;상규강복조환인반흔정황평분치료전위(12.0±1.4)분,치료16주후위(7.0±1.8)분,개선분치(5.0±1.0)분.2조환인반흔개선분치차이불명현(t=1.452,P=0.152).간역교형기조환인TAM평정우량비75.9％(22/29),상규강복조환인TAM평정우량비37.9％(11/29),차이명현(t=8.507,P=0.004).간역교형기조환인완성수공능측시시간치료전위(8.2±1.6)min,치료16주후위(7.1±1.4)min,개선시간위(1.2±1.5)min;상규강복조환인완성수공능측시시간치료전위(9.0±1.9)min,치료16주후위(6.3±1.4) min,개선시간위(2.7±2.7)min.2조환인수공능측시개선시간차이명현(t=2.618,P=0.012).간역교형기조환인일상생활활동능력평분치료전위(7.7±1.4)분,치료16주후위(10.4±1.4)분,개선분치위(2.7±1.7)분;상규강복조환인일상생활활동능력평분치료전위(7.8±1.4)분,치료16주후위(9.5±1.4)분,개선분치위(1.7±1.6)분.2조환인일상생활활동능력개선분치차이명현(t=2.246,P=0.029). 결론 간역교형기결합운동요법,유리우소상환인수부공능적회복급방치수부련축기형,치득추엄응용.
Objective To survey the curative effects of kinesitherapy in combination with self-made simple orthosis (SO) in treatment of scar contracture of burned hand in children.Methods Fifty-eight children with burns of unilateral hand and received treatment in our rehabilitation center from January 2012 to January 2014 were divided into common rehabilitation (CR) and SO groups according to the random number table,with 29 cases in each group.After the wounds were healed,patients in group CR were treated with kinesitherapy combined with hand game exercises and pressure gloves,while patients in group SO were treated with kinesitherapy combined with hand game exercises and self-made SO,which was composed of finger web dividing belt,self-adhesive bandage,and infusion set fixing plate.Before treatment and 16 weeks after treatment,scar condition was assessed with the Vancouver Scar Scale (VSS) ; hand function was evaluated by the Jebsen Test of Hand Function,and the completion time was recorded ; and the activities of daily life (ADL) was measured by the modified Barthel Index.Sixteen weeks after treatment,the range of motion was measured with the Total Active Movement (TAM) method.Data were processed with t test and chisquare test.Results The score of VSS in group SO was (12.2 ± 1.3) points before treatment and (6.7 ± 2.2) points 16 weeks after treatment,and the improvement score was (5.6 ± 1.8) points.The score of VSS in group CR was (12.0 ± 1.4) points before treatment and (7.0 ± 1.8) points 16 weeks after treatment,and the improvement score was (5.0 ± 1.0) points.There was no obvious difference in improvement score of VSS between the two groups (t =1.452,P =0.152).The ratio of excellent and good results according to TAM method in group SO was 75.9％ (22/29),while it was 37.9％ (11/29) in group CR (t =8.507,P =0.004).The completion time for the Jebsen Test of group OS was (8.2 ± 1.6) min before treatment and (7.1 ± 1.4) min after treatment,and the improvement time was (1.2 ± 1.5) min.The completion time for the Jebsen Test of group CR was (9.0 ± 1.9) min before treatment and (6.3 ± 1.4) min 16 weeks after treatment,and the improvement time was (2.7 ± 2.7) min.There was a significant difference in improvement time for the Jebsen Test between the two groups (t =2.618,P =0.012).The score of ADL in group CR was (7.7 ± 1.4) points before treatment and (10.4 ± 1.4) points 16 weeks after treatment,and the improvement score was (2.7 ± 1.7) points.The score of ADL in group CR was (7.8 ± 1.4) points before treatment and (9.5 ± 1.4) points 16 weeks after treatment,and the improvement score was (1.7 ± 1.6) points.There was a significant difference in improvement score of ADL between the two groups (t =2.246,P =0.029).Conclusions Kinesitherapy in combination with self-made SO can improve the functional recovery of burned hand in children and prevent contractures in hand,and it is worth applying generally.
