携带皮瓣的胸小肌移植重建拇对掌功能的护理及康复治疗

Nursing and rehabilitative treatment on pectoralis minor mucle taking along flap transplantation for functional reconstruction of thumb

目的报道携带皮瓣的胸小肌移植重建拇对掌功能的临床护理及康复治疗效果。方法对10例实施携带皮瓣的胸小肌重建拇对掌功能的患者，术前完善相关检查及进行心理护理。术后进行严密观察，早期辅助电刺激及CPM功能锻炼，重点辅助其拇对掌动作训练。结果10例患者经术后12—24个月随访，拇对掌功能恢复，肌力均达到4级以上，大鱼际部外形满意。结论携带皮瓣的胸小肌移植重建拇对掌功能是一种新的对掌功能重建方法，能达到恢复对掌功能的要求。而术前充分的心理护理及术后有效的康复治疗对确保手术成功，恢复对掌功能有相当重要的意义。

Objective To report the effect of clinical nursing and rehabilitative treatment on pectoralis minor taking along flap transplantation for the reconstruction of thumb. Methods Ten cases were selected and the new operation methods was adopted. The preoperative examination and mental counseling were implemented. Postoperative monitoring, early electrical stimulation and continuous passive motion functional exercise, especially the training in finger-to-thumb opposition activity were performed. Results Ten cases after operation were followed-up in 12-24 months and all were recovered within 6-12 months. Muscle strength of all 10 cases achieved above class 4 and the shape of thenar eminence was satisfactory. Conclusions Selecting part of the pectoralis minor taking along flap for transplantation to the thenar is a new method for thumb opposition reconstruction, which can achieve good outcome. In addition, sufficient preoperative mental counseling and effective postoperative rehabilitative treatment play crucial role in ensuring the success of operation and the recovery of thumb opposition function.