手术结合康复治疗手部烧伤后瘢痕挛缩的临床疗效研究

Clinical research on operation and convalescent care of deformed fingers after burn injury

目的探讨手术结合康复治疗对手部烧伤后瘢痕挛缩患者的临床疗效。方法收集2007年5月～2009年4月该院烧伤整形科收治的手部烧伤后瘢痕挛缩患者62例,接受常规的临床手术治疗和术后康复治疗,对所有患者进行术后随访6个月,测量比较治疗前和治疗后1、3和6个月患者手指关节总活动度(TAM)和日常生活活动能力(ADL)。结果 62例患者治疗前TAM与治疗后1个月比较差异无显著性(P>0.05),而治疗后3和6个月TAM值均明显高于治疗前(P<0.05)。62例患者治疗前与治疗后1个月比较,除进食、洗脸差异有显著性外,其余差异均无显著性;经治疗后3个月ADL的各项积分,除穿鞋和剪指甲外,均明显高于治疗前(P<0.05),治疗后6个月ADL的各项积分均明显高于治疗前(P<0.05)。结论手术和康复结合治疗对手部烧伤后瘫痕挛缩患者的手部功能恢复具有明显疗效,能显著改善患者的生活质量。

ObjectiveTo evaluate the advantages of operation and convalescent care on deformed fingers after burn injury.MethodsFrom May 2007 to April 2009,62 patients with deformed fingers after burn injury were treated in our hospital.All the patients had the conventional operation and convalescent care.The follow-up was 6 months for all the patients to assess TAM（total angle of motion） and ADL（activities of daily living）.ResultsIn all the cases,the TAM value at the time of entrance was not statistically different from that in one month after therapy（P〈0.05）.But the TAM values in 3 months and 6 months after therapy were statistically higher than that at the time of entrance（P〈0.05）.The ADL value at the time of entrance and one month after therapy didn＇t have statistical significance except for eating and cleaning face（P〈0.05）.But the ADL value after therapy for 3 months was statistically higher than that at the time of entrance except for wearing shoe and cutting nails（P〈0.05）.And the ADL value after therapy for 6 months was statistically higher than that at the time of entrance（P〈0.05）.ConclusionThe combined operation and convalescent care therapy is effective to promote the recovery of hand function and improve the quality of life.