早期功能锻炼在手指屈肌腱断裂术后患者中的应用效果

Application effects of early functional exercise in patients after finger flexor tendon rupture surgeries

目的:观察早期功能锻炼在手指屈肌腱断裂术后患者中的应用效果。方法:选取2020年8月至2022年8月该院收治的88例手指屈肌腱断裂术后患者进行前瞻性研究,采用随机数字表法将其分为对照组和观察组各44例。对照组采取常规锻炼,观察组采取早期功能锻炼,比较两组锻炼前后手功能(Carroll手功能评定法)评分,手握力、捏力,肌腱粘连和肌腱断裂二次手术率,日常生活能力[Barthel指数(BI)]评分,以及生命质量[生活质量综合评定问卷(GQOLI-74)]评分。结果:锻炼后,观察组抓、握、侧捏、捏、放置、旋前和旋后等Carroll手功能评分均高于对照组,差异有统计学意义(P<0.05);锻炼后,观察组手握力、三点捏力、侧捏力均大于对照组,差异有统计学意义(P<0.05);观察组肌腱粘连和肌腱断裂二次手术率为4.55%(2/44),低于对照组的18.18%(8/44),差异有统计学意义(P<0.05);锻炼后,观察组BI评分和社会功能、物质生活、躯体功能、心理功能等GQOLI-74评分均高于对照组,差异有统计学意义(P<0.05)。结论:早期功能锻炼应用于手指屈肌腱断裂术后患者可提高手功能评分、手握力、手捏力、BI评分和GQOLI-74评分,降低肌腱粘连和肌腱断裂二次手术率,效果优于常规锻炼。

Objective:To observe application effects of early functional exercise in patients after finger flexor tendon rupture surgeries.Methods:A prospective study was conducted on 88 patients after finger flexor tendon rupture surgeries who were admitted to this hospital from August 2020 to August 2022.They were divided into control group and observation group by using the random number table method,44 cases in each group.The control group took routine exercise,while the observation group took the early functional exercise.The hand function[Carroll hand function evaluation method]score,the hand grip strength,the pinch strength level,the secondary operation rate of tendon adhesion and tendon rupture,the activities of daily living[Barthel index(BI)]score,and the quality of life[general quality of life inventory(GQOLI-74)]score were compared between the two groups before and after the exercise.Results:After the exercise,the Carroll hand function scores of grasping,grasping,side pinching,pinching,placing,pronation and supination in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After the exercise,the hand grip strength,three-point pinch strength and side pinch strength of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).The secondary operation rate of tendon adhesion and tendon rupture in the observation group was 4.55%(2/44),which was lower than 18.18%(8/44)in the control group,and the difference was statistically significant(P<0.05).Further,after the exercise,the BI scores and GQOLI-74 scores of social function,material life,physical function and psychological function in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:Early functional exercise can improve hand function scores,the hand grip strength levels,the hand pinch strength levels,the BI scores and the GQOLI-74 scores,and reduce the rate of secondary operation of tendon adhesion and tendon rupture in the patients after finger flexor tendon rupture surgeries.Moreover,it is superior to the routine exercise.