徒手淋巴引流联合肌内效贴对桡骨远端骨折术后的康复疗效观察

Effect of Postoperative Rehabilitation of Distal Radius Fracture by Manual Lymphatic Drainage Combined with Kinesio Taping

目的:探索徒手淋巴引流(MLD)联合肌内效贴(KT)对桡骨远端骨折(DRF)术后肢体肿胀、疼痛、腕关节功能的康复疗效。方法:选取黄石市中心医院骨外科2019年10月-2022年2月行DRF内固定术后患者38例,随机分为对照组和观察组,对照组给予常规康复,观察组在常规康复基础上进行标准化的MLD和KT联合治疗。评估2组患者在T_(1)(治疗前),T_(2)(术后2周)和T_(3)(术后4周)的腕关节周径、手掌周径、VAS评分、Gartland-Werley评分,分析2组与时间相关性,并比较2组组间和组内差异性。结果:重复测量方差分析结果显示,在腕关节周径、手掌周径、VAS评分和Gartland-Werley评分上2组与时间相关性具有统计学差异(P<0.05),组内比较显示:T_(1)、T_(2)、T_(3)均具有统计学差异(P<0.001);组间比较显示:T_(1)4项观察指标均无统计学差异(P>0.05),T_(2)4项指标均有统计学差异(P<0.05),T_(3)腕关节周径、手掌周径、VAS评分无统计学差异(P>0.05),但2组间Gartland-Werley评分差异显著(P<0.05)。结论:MLD联合KT能有缓解DRF术后早期肢体肿胀和疼痛,且在提升腕关节功能上有持续疗效,但需更多临床研究进一步验证。

Objective:To explore the effects of manual lymphatic drainage combined with kinesio taping application on limb swelling,pain and wrist joint function Postoperative of distal radius fractures.Methods:38 patients with distal radius fracture after internal fixation were randomly divided into the control group and the combined group.The control group received routine rehabilitation treatment,and the combined group received standardized manual lymphatic drainage combined with kinesio taping on the basis of routine rehabilitation.Wrist circumference,palm circumference,VAS score and Gartland-Werley score were measured at T_(1)(before treatment),T_(2)(2 weeks after surgery)and T_(3)(4 weeks after surgery),the correlation between groups and time was analyzed,and the differences between and within groups were compared.Results:Repeated measure ANOVA showed significant correlation with time in wrist circumference,palm circumference,VAS score and Gartland-Werley score(P<0.05),and intra-group comparison showed that there were statistical differences among T_(1),T_(2) and T_(3)(P<0.001).Comparison between groups shows that:There were no significant differences in the 4 indexes at T_(1)(P>0.05),and There were significant differences in the 4 indexes at T_(2)(P<0.05).There were no significant differences in wrist circumference,palm circumference and VAS score at T_(3)(P>0.05),but there were significant differences in Gartland-Werley score at T_(3)(P<0.05).Conclusion:Manual lymphatic drainage combined with kinesio taping can relieve limb swelling and pain symptoms after distal radius fractures in early stage,and it is sustained efficacy in wrist dysfunction,but more large-sample clinical studies are needed to further verify.