系统康复治疗对腹部带蒂皮瓣引发废用性肩关节僵硬的干预效果

Effects of Systemic Rehabilitation in Treating Disuse Shoulder Stiffness after Abdominal Pedicle Flap Graft

目的研究功能康复对上肢创面行腹部带蒂皮瓣转移术引发废用性肩关节僵硬治疗的效果。方法选择2006年8月至2010年8月60例上肢创面带蒂皮瓣转移术患者,按照入院先后顺序分为观察组(30例)与对照组(30例),观察组断蒂术后即通过手法按摩、局部理疗、主动活动等方法进行康复治疗,对照组行常规治疗。观察两组患者在断蒂术后1d、术后2周肩关节僵硬程度、功能恢复及关节活动疼痛情况。结果两组患者术后肩关节僵硬的发生率为100%;断蒂术后2周,观察组肩关节僵硬改善程度及功能恢复、疼痛情况明显优于对照组(均P<0.01)。结论系统康复治疗可明显促进上肢带蒂皮瓣术后肩关节功能恢复,减少废用性肩关节僵硬症的发生。

Objective To study the effect of systemic rehabilitation on disuse shoulder stiffness caused by abdominal pedicle flap graft in wounds of the upper limbs.Methods From August 2006 to August 2010,60 patients with abdominal pedicle flap graft in wounds of the upper limbs were divided into observation group（n=30） and control group（n=30） according to the admission sequence.The patients in the observation group underwent the systemic rehabilitation of massage,local therapy and active motion after abdominal pedicle flap graft.While the patients in the control group underwent the routien treatment.The degree of shoulder stiffness,the status of functional recovery and the pain in joint activities were observed in the patients of both groups at 1 d and 2 weeks after abdominal pedicle flap graft.Results The postoperative incidence of shoulder stiffness was 100%.The shoulder stiffness,the status of functional recovery and the pain in joint activities were all significantly improved two weeks after abdominal pedicle flap graft in the observation group than in the control group（P0.01）.Conclusion Systemaitic rehabilitation can promote the function recovery of（shoulder） joint after upper pedicle flap surgery and reduce the incidence of disuse shoulder stiffness.