体外冲击波治疗对中晚期手掌部碾压伤功能障碍的影响

Extracorporeal shock wave treatment for palm crush injuries

目的观察常规中晚期手掌碾压伤术后患者在常规康复治疗方案的基础上增加体外冲击波治疗后的临床疗效。方法收集临床确诊为手掌部碾压伤且病程在3个月以上的患者40例,按随机数字表法分为常规治疗组和联合治疗组,每组患者20例。常规治疗组给予常规关节松动、超声波、肌肉力量训练、作业训练等治疗,每日治疗1次,10 d为1个疗程,连续治疗2个月。联合治疗组在常规治疗组治疗方案的基础上增加体外冲击波治疗,体外冲击波治疗每周3次,连续治疗2个月。于治疗前、治疗1个月后和治疗2个月后对2组患者的上肢综合功能(DASH评分)、手部力量(握力大小)、手部灵活性(采用9孔木插板试验)进行评估。结果治疗2个月后,2组患者的DASH评分、9孔木插板评分、握力评分与组内治疗前比较,差异均有统计学意义(P<0.05),且联合治疗组治疗后的DASH评分、9孔木插板时间、握力值分别为(31.0±10.1)分、(22.7±4.1)s、(25.7±5.1)kg,与常规治疗组治疗2个月后比较,差异均有统计学意义(P<0.05)。结论中晚期手掌部碾压伤患者在常规康复治疗基础上增加体外冲击波治疗,可以改善患者手部的粗大及精细功能,促进手功能恢复。

Objective To observe the clinical effect of extracorporeal shock wave treatment in the treatment of functional disorders after a palm crush injury.Methods Forty patients who had experienced a hand crush injury more than 3 months previously were randomly divided into a control group and a combination group,each of 20.Both groups were given routine joint mobilization,ultrasound treatment,muscle strength training and occupational therapy every day in ten day units for 2 months.The combination group also received extracorporeal shock wave therapy three times a week for the two months.Before the experiment and after one and two months of treatment,both groups′upper limb functioning was evaluted using the DASH score,grip strength and hand flexibility in the 9-hole wood board test.Results After 2 months of treatment,significant improvement was observed in all of the measurements with both groups.The average scores of the combination group on all three tests were by then significantly better than the control group′s averages.Conclusions Adding extracorporeal shock wave therapy to routine rehabilitation can improve the rough and fine functioning of a crushed hand.