早期康复介入对膝部烧伤患者屈曲畸形的预防作用

Preventive Effects of Early Rehabilitation Treatment in Flexion Contracture of the Patients with Knee Burn

目的:探讨早期康复介入对预防膝部烧伤患者屈曲畸形的作用。方法:烧伤累及膝部患者30例,随机分为康复组及对照组各15例,均按烧伤常规治疗,待烧伤创面愈合后康复组立即使用动态关节矫形器固定为主,配合硅凝胶瘢痕贴膜贴敷和运动疗法等早期运动训练;对照组给予硅凝胶瘢痕贴膜贴敷。治疗前后评定患者瘢痕增生及膝关节主动活动度的变化。结果:随访18个月,2组患者膝关节主动活动度与治疗前比较均明显提高,康复组明显高于对照组(均P<0.05)。治疗后膝部瘢痕评定,康复组显效率明显高于对照组(P<0.01)。结论:早期综合协调应用动态关节矫形器、运动训练和敷贴硅凝胶膜,可有效抑制烧伤肥厚性瘢痕增生,预防关节畸形和肢体肌肉萎缩,是全身无中厚供皮区患者治疗的最佳选择。

Objective： To explore the preventive effects of early rehabilitation treatment in flexion contracture of the patients with knee burn.Methods： Fifteen cases of knee burn were selected and followed up for 12 to 18 months after the treatment.The patients with knee burn were randomly divided the rehabilitation group and the control group.Fifteen cases in the rehabilitation group received not only the general burn treatments,but also the silica gel,dynamic joint orthosis and sports therapy,etc.Those in the control group only received the silica gel and the general burn treatments.The hypertrophic scar and the active range of motion of knee joint were assessed 18 months after treatment.Results： After treatment for 18 months,the active range of motion of knee joint were improved in both two groups,and more significantly in the rehabilitation group（P〈0.05）.The effective rate in the rehabilitation group was significantly higher than in the control group（P〈0.01）.Conclusion： The early rehabilitation with the silica gel,dynamic joint orthosis and sports therapy can prevent hypertrophic scar proliferation,and avoid joint deformity and muscular atrophy in the limbs,especially for the burn patients with no moderate and thick skin graft donor site.