前臂屈指肌腱修复术后功能恢复的影响因素分析

Analysis of the Factors Affecting the Function Recovery after the Forearm Flexor Tendon Injuries Repairment

目的：探讨影响前臂屈指肌腱修复术后功能恢复效果的因素，以利于制定合理的手术及康复方案。方法：对2011年1月～2012年10月解放军第401医院手外科收治的58例（其中男性41例，女性17例，年龄13．62岁，平均33．8岁）屈指肌腱在前臂损伤患者的伤因及手术方式进行回顾、分析总结并进行随访，分析其受伤严重程度、手术方式、术后功能锻炼情况。结果：术后随访54例，失访4例，随访时间为术后3-6个月。根据中华医学会手外科学会手功能评定试用标准评定54例前臂屈指肌腱损伤修复术后的患手的恢复情况，其中优31例，良16例，中5例，差2例。指浅、深屈肌腱同时损伤较单纯指浅屈肌腱损伤修复术后粘连发生率较高，手功能的优良率较低（P〈0．05），合理应用防粘连技术和术后进行系统功能锻炼的患者术后手功能的优良率分别较未合理应用防粘连技术和术后未进行系统功能锻炼的患者显著升高（P〈0．05）。结论：手术切口是否合理的延长，术中操作是否重视无创操作，是否合理的应用防粘连技术以及缺乏系统的功能锻炼以及肌腱断端吻合质量是影响前臂屈指肌腱修复术后功能恢复的重要因素。

Objective： To study the factor effect the recovery after forearm flexor tendon injuries repaired, in order to formulate rational surgery and rehabilitation scheme. Methods： From Jan 2011 to Oct 2012, the 58 cases forearm flexor tendon injuries NO.401 Hospital admitted （male 41 cases, emale 17cases, age 13-62 years, average age33.8 years）, review and analysis the casuse of injury and surgery. Discus from the severity, surgery methods and the recovery after surgery. Results： 54 cases were followed-up, 4 cases were lost. The follow-up time was 3 to 6 months after surgery. According to the CMA hand function tentative standard, in 54 cases, 31 cases were excellent, 16 cases were good, 5 eases were middle, 2 cases were invalid. Superficial flexor tendon and deep flexor tendon both injury got more adhesion than superficial flexor tendon injury, the hand function was lower （P〈0.05）. The hand function good rate significantly increased in the patients using anti-adhesion technology and having system function exercise than the patients who hadn＇t been treated so （P〈0.05）. Conclusion： No reasonabal extend incision, not given attention to Noninvasive operation, low quality repair, do not use the antiblocking technology reasonabally, do not have system ftmction exercise are very important factors to the function recovery after forearm flexor tendon injuries repaired.