系统性康复训练对腹部带蒂皮瓣术后废用性肩关节功能障碍的干预效果

Intervention effects of systemic rehabilitation training on postoperative disuse shoulder dysfunction after abdominal pedicled skin flap transplantation

目的评价系统性康复训练对手外伤患者行腹部带蒂皮瓣修复术后废用性肩关节功能障碍的干预效果。方法选取山东大学附属省立医院手足外科2014年3-4月收治的单侧手外伤行腹部带蒂皮瓣修复术患者45例对照组，2014年6-7月收治的单侧手外伤行腹部带蒂皮瓣修复术患者47例为试验组。对照组采取常规治疗护理，试验组由医生、护士和治疗师于术前、术中和术后采取系统性康复训练。采用肩关节功能评价量表对两组患者在腹部皮瓣断蒂术后第1天和第7天的肩关节功能进行评分，使用SPSS20．0软件进行统计分析。结果术后第1天和第7天，试验组患者的肩关节功能评分分别为（72．96±4．72），（87．91±4．74）分，对照组分别为（65．11±6．74），（79．38±7．31）分，两组比较差异有统计学意义（t值分别为6．492，6．677；P〈0．01）。结论系统性康复训练方案中要求明确、指导规范，便于执行，能够显著改善手外伤患者行腹部带蒂皮瓣修复术后的废用性肩关节功能障碍。

Objective To evaluate the intervention effects of systemic rehabilitation training on postoperative disuse shoulder dysfunction in hand injury patients received abdominal pedicled skin flap transplantation. Methods The 92 patients received same operation of abdominal pedicled skin flap surgery for unilateral hand in Hand and Foot Surgery Department of Provincial Hospital Affiliated to Shandong University and were divided into two groups, in which 45 patients as control group from March to April 2014 and 47 patients as experimental group from June to July 2014. The patients of control group received conventional therapy and nursing, while the ones of experimental group received systematic rehabilitation training by nurses and doctors before, during and after operation. Shoulder function was scored at the day 1 and day 7 after the pedicle division operation according to the shoulder joint function assessment scale, and we employed SPSS 20. 0 to analyze the results. Results The shoulder function scores of experimental group patients were （72.96 ± 4.72） and （87.91 ±4. 74） at the day 1 and day 7 after the pedicle division operation, which were better than the scores of control group patients, [ （65.11 ±6.74） and （ 79.38 ± 7.31 ） ] （ t = 6. 492,6. 677 ; P 〈 0. 01 ）. Conclusions The systemic rehabilitation training program, which requirements were definite, and guidance was standard and easy to perform, can significantly improve the shoulder function of the patients received abdominal pedicled skin flap transplantation.