上肢骨折与软组织损伤后功能障碍患者的康复治疗

The therapeutic effect of systematic rehabilitation intervention patients with upper limb dysfunction caused by fracture and soft tissue injury

目的观察系统、综合康复治疗上肢骨关节损伤后功能障碍患者的疗效。方法选择上肢骨折与软组织损伤后肩、肘及腕关节功能障碍患者45例,进行系统的综合康复治疗,并于治疗前及治疗2个月后对患者关节活动范围(ROM)、疼痛程度、主要肌群肌力及日常生活活动(ADL)能力进行评定。结果ROM(除肩外展外)治疗前、后比较,差异有统计学意义(P<0.01);主要肌群肌力治疗前、后比较,差异有统计学意义(P<0.01);目测类比评分(VAS)与功能独立性评分(FIM)治疗前、后比较,差异均有统计学意义(P<0.01)。结论系统的康复治疗能有效地改善上肢骨关节损伤患者的上肢功能及ADL能力。

Objective To observe the therapeutic effects of systematic rehabilitation treatments on patients with upper limb dysfunction caused by fracture and soft tissue injury. Methods This study observed 45 cases of industrial injuries, with a involvement of 25 shoulder joints, 20 elbow and 23 wrist joints. All the patients were intervened with comprehensive rehabilitation treatments for 2.2 ± 0.9 months, which included physiotherapy（ joint mobilization, stretch technique, strength exercise, CPM, physical agent therapy and hydrotherapy） , occupational therapy and orthosis. ROM, pain, the muscle strength of main muscle groups and ADL were assessed before and 2 months after treatment, respectively. Results There was significant difference with regard to ROM of the involved joints except for shoulder abduction after treatment when compared with those before the treatment （ P 〈 0.01 ）. The muscle strength of the main muscle groups was compared pre-and post-treatment, and revealed a significant difference （P 〈 0. Ol ） , the pain and ADL scores were also significantly improved after treatment （ P 〈 0.01 ）. Conclusion Systematic rehabilitation intervention can significantly improve the upper limb function and ADL performances of patients with fracture and soft tissue injuries in the upper limb.