手植皮术后蜡疗联合矫形器治疗的康复疗效观察

Effect of kerotherapy combined with kinesitherapy in rehabilitation of hand after skin graft

目的观察蜡疗联合矫形器治疗在手植皮手术后康复治疗中的疗效。方法选取2009-06至2013-06,在空军总医院烧伤整形科收治的手部植皮患者63例,按康复方法分为综合康复组(32例)和常规康复组(31例)。常规康复组给予压力治疗、日常生活动作训练、主动训练和药物治疗。综合康复组还加用蜡疗和矫形器治疗。两组患者在康复治疗6个月后对患者手部疼痛、瘢痕增生情况和手功能情况进行评价。结果康复开始时综合康复组疼痛评分和常规康复组差异无统计学意义(P=0.086)。经康复治疗后,综合康复组疼痛评分为(1.56±0.27)分明显低于常规康复组(2.92±0.36)分,差异有统计学意义(P=0.012)。综合康复组瘢痕增生在治疗后评分(4.36±0.78)分明显低于常规治疗组(5.92±0.91)分,差异有统计学意义(P<0.05)。综合康复组手功能TAM和Barthel评分分别为(238.5±12.7)分和(87.2±6.76)分,均明显高于常规康复组的(58.2±5.9)分和(70.2±4.2)分,差异有统计学意义(P<0.05)。结论蜡疗联合矫形器治疗能促进植皮手术后手功能的恢复。

Objective To study curative effect of kerotherapy combined with kinesitherap in rehabilitation of hand receiving skin graft. Methods Sixty-three patients with hands receiving skin graft in Department of Burn and Plastic Surgery, Air Force General Hospital from June 2009 to June 2013 were divided into conventional rehabilitation group （31 patients） and combined rehabilitation group （32 patients）. Patients in conventional rehabilitation group were treated with pressure therapy, daily exercises, active training, and medicine. Patients in combined rehabilitation group were treated with kerotherapy with kinesitherapy, in addition to pressure thera- py, daily exercises, active training, and medicine. All patients were assessed on scar, pain, and hand function after half a year. Results There was no signficant difference in scores of VAS between conventional rehabilitation group and combined rehabilitation. The scores of VAS in combined rehabilitation group（ 1.56 ± 0.27 ） were obviously lower than those in conventional rehabilitation group （2.92 ± 0.36, P = 0. 012 ） after half a year. There was significant difference in scores of VSS between combined rehabilitation group （4.36 ±0.78） and conventional rehabilitation group （2.92 ±0.36, P =0. 012）. The scores of TAM and Barthel in combined rehabil- itation group （238.5 ± 12.7, 87.2 ± 6.76） were higher than those in conventional rehabilitation group （58.2 ± 5.9, 70.2 ± 4.2, P = 0. 023, P = 0. 013 ）. Conclusions Kerotherapy with kinesitherapy in rehabilitation can improve function of hand treated by skin graft, and it is worthy of applying generally in hand rehabilitation.