体外冲击波在烧伤爪形手整形术后康复治疗中的应用效果

Application effect of extracorporeal shock wave in the rehabilitation of postburn claw hand after plastic surgery

目的观察体外冲击波用于烧伤爪形手整形术后康复治疗的临床效果。方法2019年1月至2022年12月于上海交通大学医学院附属第九人民医院整复外科接受整形康复医疗的烧伤爪形手患者27例(42只患手)。根据康复治疗方法将患者分为观察组(13例,21只患手)和对照组(14例,21只患手),其中对照组在烧伤爪形手整形术后采用常规康复治疗方案,观察组在此基础上增加体外冲击波治疗。对比观察两组康复治疗前及治疗2、4、8周手指关节总活动度(TAM)、疼痛视觉模拟评分(VAS)以及手部日常生活活动能力(ADL)评分变化。结果治疗2、4、8周,观察组患者TAM均高于对照组(t=-9.83、-12.58、-9.32,P<0.05),VAS评分均低于对照组(t=4.26、9.54、9.07,P<0.05),ADL评分均高于对照组(t=-7.83、-11.39、-11.40,P<0.05)。结论体外冲击波治疗能够显著降低烧伤爪形手整形术后常规康复进程中伴随的疼痛,同时增加术后手指关节的整体活动度,改善手部日常生活功能。

Objective To observe the clinical effect of extracorporeal shock wave in the rehabilitation of postburn claw hand after plastic surgery.Methods From January 2019 to December 2022,27 patients(42 affected hands)with postburn claw hand received plastic and rehabilitation treatment at Reconstructive Surgery Department of Shanghai Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine.The patients were divided into observation group(13 patients,21 affected hands)and control group(14 patients,21 affected hands)according to the rehabilitation treatment methods.The control group received routine rehabilitation treatment after plastic surgery,while the observation group received additional extracorporeal shock wave treatment on this basis.Compared the changes in total active motion(TAM)of finger,visual analogue scale(VAS),and activities of daily life(ADL)of hand between two groups before and after 2,4,and 8 weeks of rehabilitation treatment.Results After 2,4,and 8 weeks of treatment,the TAM of the observation group were higher than those of the control group(t=-9.83,-12.58,-9.32,P<0.05),the VAS scores were lower than those of the control group(t=4.26,9.54,9.07,P<0.05),and the ADL scores were higher than those of the control group(t=-7.83,-11.39,-11.40,P<0.05).Conclusion Extracorporeal shock wave therapy can significantly reduce the pain associated with routine rehabilitation after postburn claw hand plastic surgery,while increasing the overall range of motion of the finger joints and improving the function of the hand after surgery.