地震后截肢患者残肢的临床评定和康复治疗

Clinical evaluation and treatment of stumps in amputees injured in Wenchuan earthquake

目的分析地震致截肢患者残肢的特点和原因、观察康复治疗的效果。方法从残端皮肤情况、残肢形态、残肢长度、残肢肿胀、残肢关节活动度和残肢肌力等方面对52条残肢进行评定，并进行物理治疗、残肢塑形和运动治疗。结果52条残肢中，残端有溃疡或窦道、残肢肿胀、圆锥形残肢和短残肢分别占76％、73％、34％和40％，残肢关节活动受限者占42％，所有患者残肢肌力明显减退。经康复治疗后，残肢无肿胀、溃疡或窦道完全愈合，残肢形状、关节活动度和肌力明显改善，已达到假肢装配条件，均装配假肢，并获得良好的功能。结论地震后截肢不良残肢发生率高，综合康复治疗能明显改善残肢条件，早期康复治疗对促进患者康复，安装假肢具有重要意义。

Objective To analyze the feature and cause of stumps of amputees after Wenchuan earthquake, and study the effects of rehabilitation treatment for stumps. Methods Fifty-two cases with stump limbs post-amputation were evaluated, including stump skin status, stump shape, stump length, stump swelling, range of motion （ROM） of joint and strength of stump, and were treated with physical therapy, stump moulding and kinesiotherapy. Results The incidences of stump ulcer, stump swelling, conical stump, short stump and limitation of ROM of joint in all 52 cases were 76% , 73% , 34% , 40% and 42% respectively. After rehabilitation treatment stump ulcers healed, stump swelling eliminated; stump shape, ROM of joint and muscle strength improved obviously. All poor stumps could be fit with the prosthetic limb and get good function. Conclusion The incidences of poor stump limb post-amputation after earthquake were high. Rehabilitation treatment can improve the stump condition. Early comprehensive rehabilitative intervention after amputation is important for fitting the prosthetic limb to the stump.