CAJ | 학술논문

目的探讨早期运动对指V区屈肌腱损伤伴尺神经损伤修复术后患者手部功能的影响.方法选取指V区屈肌腱损伤伴尺神经损伤修复术后患者53例,按照随机数字表法将其分为观察组(26例、88指)和对照组(27例、91指).术后给予2组患者常规治疗;术后4周时,2组患者开始进行主被动活动训练,观察组在此基础上于术后第8天开始进行早期运动.术后第12周,采用总主动活动度(TAM)测定法、周围神经感觉功能评价及肩臂手残疾问卷(DASH)对2组患者的手部功能进行评定,记录患者的腕关节主动活动度及握力.结果术后第12周时,观察组TAM明显优于对照组,差异有统计学意义(P＜0.05).与对照组比较,观察组在腕关节掌屈、背伸、尺偏、桡偏4种状态下的主动活动度[(56.08±11.05)°、(49.31±9.67)°、(32.50±8.10)°、(23.65±6.34)°]较为优异,差异有统计学意义(P＜0.05).术后第12周时,观察组握力百分比、神经修复后手功能及DASH值均优于对照组,差异有统计学意义(P＜0.05).结论早期运动可促进指V区屈肌腱损伤伴尺神经损伤修复术后患者的手部功能恢复,有效提高患者对患手功能恢复的满意度,值得临床应用、推广.
목적 탐토조기운동대지V구굴기건손상반척신경손상수복술후환자수부공능적영향.방법 선취지V구굴기건손상반척신경손상수복술후환자53례,안조수궤수자표법장기분위관찰조(26례、88지)화대조조(27례、91지).술후급여2조환자상규치료;술후4주시,2조환자개시진행주피동활동훈련,관찰조재차기출상우술후제8천개시진행조기운동.술후제12주,채용총주동활동도(TAM)측정법、주위신경감각공능평개급견비수잔질문권(DASH)대2조환자적수부공능진행평정,기록환자적완관절주동활동도급악력.결과 술후제12주시,관찰조TAM명현우우대조조,차이유통계학의의(P＜0.05).여대조조비교,관찰조재완관절장굴、배신、척편、뇨편4충상태하적주동활동도[(56.08±11.05)°、(49.31±9.67)°、(32.50±8.10)°、(23.65±6.34)°]교위우이,차이유통계학의의(P＜0.05).술후제12주시,관찰조악력백분비、신경수복후수공능급DASH치균우우대조조,차이유통계학의의(P＜0.05).결론 조기운동가촉진지V구굴기건손상반척신경손상수복술후환자적수부공능회복,유효제고환자대환수공능회복적만의도,치득림상응용、추엄.
Objective To explore the effects of early active mobilization on hand function after zone 5 flexor tendon and ulnar nerve repair.Methods Fifty-five patients who had received primary repair in zone 5 of a flexor tendon and the ulnar nerve were randomly divided into an observation group (26 cases, 88 digits) and a control group (27 cases, 91 digits).Both groups were given routine treatment after the operation, and started to do active and passive exercise 4 weeks later.The observation group was additionally forced to do active range of motion exercise training starting 8 days after the operation.Twelve weeks after the operation, the hand function of both groups was assessed using the total active motion (TAM) scoring system of the American Society for Surgery of the Hand, peripheral nerve function evaluation and the disabilities of arm-shoulder-hand (DASH) scale.Results At the end of the treatment, the average TAM score of the observation group was significantly better than that of the control group.The average active movement range of the wrist in palm flexion, dorsal extension, ulnar deviation and in radial deviation were all significantly better than in the control group.Grip strength, overall hand function and DASH score were also significantly better on average.Conclusion Early active mobilization following flexor tendon and ulnar nerve repair can effectively promote the recovery of hand function.