早期康复训练并物理因子治疗对创伤性周围神经损伤后手功能恢复的影响

Effect of Early Rehabilitation Training and Physical Therapy on Hand Function Following Peripheral Nerve Injury

目的:观察在治疗师协助下早期运动训练并物理因子治疗对创伤性上肢周围神经损伤术后手功能恢复的疗效。方法:周围神经损伤术后手功能障碍患者60例,随机分为观察组和对照组各30例。观察组患者术后2～7 d在治疗师协助下开始静力夹板或动力牵引夹板使用下的运动训练并配合物理因子疗法;术后3周去除夹板主动运动训练为主和物理因子疗法。对照组术后2～7 d自行运动训练加物理因子疗法。治疗前后2组均进行手功能评定。结果:治疗3个月后,2组手功能综合评分与治疗前比较均有提高(P<0.01),2组间比较,观察组明显高于对照组(11.2±1.4与9.8±1.4,P<0.01)。结论:专业人员协助下早期系统的康复训练及物理因子治疗可显著提高周围神经损伤致手功能障碍的疗效。

Objective To investigate the efficacy of early rehabilitation training combined with physical agent for motor recovery of hand function in patients with traumatic peripheral nerve injury. Methods Sixty patients with hand functional deficits after traumatic peripheral nerve injury on upper extremity were randomly divided into a rehabilitation group （n= 30） and a control group （n=30）. In rehabilitation group, the patients were treated with functional training with static splint or dynamical splint under the supervision of therapists in combination with physical agent from 2--7 days post operation, and then active movement training without splint from 3rd week post operation. The control group was treated with self-movement training from 2nd to 7th day post operation. The assessment of hand function was performed before and 3 months after training in both groups respectively according to Chinese medical association hand surgery academy upper extremity function assessment probation standard. Results After treatment for 3 months, the average score of the hand function in rehabilitation group was significantly higher than in control group （P〈0. 01）. Conclusion Early rehabilitation training with therapists involvement could improve the hand function more effectively than self-movement training following traumatic peripheral nerve injury.