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自研手多功能支具在手部皮肤逆行撕脱伤康复治疗中的应用研究 预览

Application of Self-hand Multifunctional Brace in Rehabilitation of Retrograde Avulsion of Hand Skin
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摘要 目的:探讨自研手多功能支具应用于手部皮肤逆行撕脱伤患者的临床治疗效果。方法:2014年7月-2017年7月,对佛山市中医院骨二科急诊116例术后住院患者进行研究,按照入院顺序,随机分成支具治疗组(常规治疗基础上,采用自研手多功能支具,应用于患者手术和术后康复过程)和常规治疗组(常规性清创、消毒、清洗、肌腱修复和植皮缝合,最后使用VSD技术并使用敷料覆盖),每组58例。比较两组患者患指的虎口角及虎口距离增加情况、手指活动度、TAM评级和术后并发症发生情况。结果:术后第8周、第12周支具治疗组虎口角及虎口距离增加情况、主动活动范围、最大伸展角度、最大屈曲角度和TAM评级优于常规治疗组,差异有统计学意义(P<0.05)。组内不同时点比较,两组患者随着时间迁移,虎口角和虎口距离增加情况、主动活动范围、最大伸展角度及最大屈曲角度均有明显上升,TAM评级优良率增高,差异有统计学意义(P<0.05)。支具治疗组术后关节僵硬、肌腱粘连、虎口挛缩发生率明显少于常规治疗组,差异有统计学意义(P<0.05)。结论:手部支具应用于手部皮肤逆行撕脱的患者,可以显著改善患者术后瘢痕挛缩、肌腱粘连等病情,进而促进患者手指功能的恢复。 Objective In patients with hand skin injury (retrograde avulsion), a multifunctional brace was used for adjuvant treatment. Methods From July 2014 to July 2017, the study of 116 cases of hand degloving injury patients, randomly divided into treatment group with a (based on regular treatment, using the research, with a multifunctional applied to patients with surgery and postoperative rehabilitation process) and conventional treatment group (routine debridement, sterilization, cleaning, tendon suture repair and graft, finally using the VSD technique and using dressing). Before and after treatment, the differences between the two groups in the Angle of tiger's mouth, the distance between tiger's mouth, the degree of finger movement and TAM rating were compared, and the statistical differences in postoperative complications and clinical efficacy between the two groups were compared. Results At the 8 and 12 weeks after operation, the increase of tiger mouth angle and distance, active range of motion, maximum extension angle, maximum flexion angle and TAM rating of the brace treatment group were better than those of the conventional treatment group, and the differences were statistically significant(P <0.05). Comparing the two groups at different time points, the distance between the tiger mouth and the tiger mouth increased, the active range of motion, the maximum extension angle and the maximum flexion angle increased significantly, and the excellent and good rate of TAM rating increased with the time migration(P <0.05). The incidence of joint stiffness, tendon adhesion and tiger mouth contracture in the brace treatment group was significantly lower than that in the conventional treatment group(P <0.05). Conclusion The application of hand support in patients with retrograde avulsion of hand skin can significantly improve postoperative conditions (scar contracture, tendon adhesion, etc.), thus promoting the recovery of finger function.
作者 王朝辉 高峻青 张家盛 付记乐 杨松 罗桦杰 詹晓欢 WANG Zhao-hui;GAO Jun-qing;ZHANG Jia-sheng;FU Ji-le;YAGN Song;LUO Hua-jie;ZHAN Xiao-huan(Department of Orthopedics,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong,China)
出处 《中国美容医学》 CAS 2019年第7期58-62,共5页 Chinese Journal of Aesthetic Medicine
基金 佛山市科技创新平台建设项目(编号:2014AG10005) 佛山市十三五医学重点专科建设项目(编号:FSZDZK135019) 佛山市卫生和计划生育局医学科研课题(编号:20170083).
关键词 多功能支具 手部皮肤 逆行撕脱伤 瘢痕挛缩 手部功能 multi-function support hand skin retrograde avulsion injury scar contracture hand function
作者简介 第一作者:王朝辉,医学硕士,主治医师;研究方向:手足显微外科、骨髓炎及肢体矫形与功能重建;通信作者:高峻青,主任医师,硕士生导师,教授;主要从事手足显微整形、创伤及修复的科研和临床工作;E-mail:wnchhi@163.com.
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