目的:研究早期综合康复训练对断指再植患者术后再植指功能恢复及生活质量的影响。方法:选取笔者医院2018年1月-2021年12月收治的212例断指再植患者,随机分为观察组(n=106,应用早期综合康复训练护理模式)和对照组(n=106,应用常规护理模式...目的:研究早期综合康复训练对断指再植患者术后再植指功能恢复及生活质量的影响。方法:选取笔者医院2018年1月-2021年12月收治的212例断指再植患者,随机分为观察组(n=106,应用早期综合康复训练护理模式)和对照组(n=106,应用常规护理模式)。比较两组患者再植指功能恢复情况、疼痛评分、血液循环状态、患者焦虑自评量表(Self-rating anxietyscale,SAS)、抑郁自评量表(Self-ratingdepressionscale,SDS)、生活质量综合评定问卷(Generic quality of life inventory 74,GQOLI-74)评分及并发症发生情况。结果:护理干预后,观察组患者再植指功能恢复优良率(99.06%)高于对照组的(93.40%)(P<0.05);护理干预前,两组患者再植指疼痛评分、血液循环状态、患者SAS、SDS、GQOLI-74评分比较差异均无统计学意义(P>0.05);护理干预后,两组患者疼痛评分、SAS、SDS评分均降低,且观察组均低于对照组,差异均有统计学意义(P<0.05);护理干预后,两组患者再植指血液循环状态及生活质量均改善,且观察组改善优于对照组,差异均有统计学意义(P<0.05);术后6个月内,观察组并发症发生率低于对照组(P<0.05)。结论:早期综合康复训练护理模式对于改善断指再植患者再植指功能恢复情况、降低患者疼痛程度、减少患者负性情绪、改善患者血液循环状态、降低患者并发症发生率及提升患者生活质量方面具有积极而重要的意义,值得临床推广。展开更多
Purpose： Distal finger amputations pose a therapeutic problem with the distal fragment quality. Reimplantation remains the reference treatment for functional and aesthetic recovery of the hand. The interest of this s...Purpose： Distal finger amputations pose a therapeutic problem with the distal fragment quality. Reimplantation remains the reference treatment for functional and aesthetic recovery of the hand. The interest of this study is to propose the reposition flap as an alternative to different hedging techniques in the proximal stump, in many situations where revascularization is impossible. It consists in osteosynthesis of the bone fragment and its coverage by a pedicled local flap. Methods： The technique of reposition flap was evaluated retrospectively between 2003 and 2016 through a study of 13 patients compiled in Nabeul orthopedic department. For each patient, the sensitivity, the pulp trophicity, the interphalangeal mobility, the digital length, the appearance of the nail and radiological consolidation were evaluated. Results： The reposition flap keeps more than 80% of the length of p3. This procedure improves nail aesthetics in comparison with the regularizations. There is no significant difference in sensitivity of the pulp or of the mobility of the distal inter-phalangeal （DIP） joint as a function of the technique studied. However there is a significant difference in average test of the Quick Dash （350 against 500 for regularizations）. Conclusion： The reposition flap seems to be a good alternative to regularization in the context of trans-p3 fingers amputations, in which the distal fragment is not revascularizable. It allows better aesthetic and functional results.展开更多
文摘目的:研究早期综合康复训练对断指再植患者术后再植指功能恢复及生活质量的影响。方法:选取笔者医院2018年1月-2021年12月收治的212例断指再植患者,随机分为观察组(n=106,应用早期综合康复训练护理模式)和对照组(n=106,应用常规护理模式)。比较两组患者再植指功能恢复情况、疼痛评分、血液循环状态、患者焦虑自评量表(Self-rating anxietyscale,SAS)、抑郁自评量表(Self-ratingdepressionscale,SDS)、生活质量综合评定问卷(Generic quality of life inventory 74,GQOLI-74)评分及并发症发生情况。结果:护理干预后,观察组患者再植指功能恢复优良率(99.06%)高于对照组的(93.40%)(P<0.05);护理干预前,两组患者再植指疼痛评分、血液循环状态、患者SAS、SDS、GQOLI-74评分比较差异均无统计学意义(P>0.05);护理干预后,两组患者疼痛评分、SAS、SDS评分均降低,且观察组均低于对照组,差异均有统计学意义(P<0.05);护理干预后,两组患者再植指血液循环状态及生活质量均改善,且观察组改善优于对照组,差异均有统计学意义(P<0.05);术后6个月内,观察组并发症发生率低于对照组(P<0.05)。结论:早期综合康复训练护理模式对于改善断指再植患者再植指功能恢复情况、降低患者疼痛程度、减少患者负性情绪、改善患者血液循环状态、降低患者并发症发生率及提升患者生活质量方面具有积极而重要的意义,值得临床推广。
文摘Purpose： Distal finger amputations pose a therapeutic problem with the distal fragment quality. Reimplantation remains the reference treatment for functional and aesthetic recovery of the hand. The interest of this study is to propose the reposition flap as an alternative to different hedging techniques in the proximal stump, in many situations where revascularization is impossible. It consists in osteosynthesis of the bone fragment and its coverage by a pedicled local flap. Methods： The technique of reposition flap was evaluated retrospectively between 2003 and 2016 through a study of 13 patients compiled in Nabeul orthopedic department. For each patient, the sensitivity, the pulp trophicity, the interphalangeal mobility, the digital length, the appearance of the nail and radiological consolidation were evaluated. Results： The reposition flap keeps more than 80% of the length of p3. This procedure improves nail aesthetics in comparison with the regularizations. There is no significant difference in sensitivity of the pulp or of the mobility of the distal inter-phalangeal （DIP） joint as a function of the technique studied. However there is a significant difference in average test of the Quick Dash （350 against 500 for regularizations）. Conclusion： The reposition flap seems to be a good alternative to regularization in the context of trans-p3 fingers amputations, in which the distal fragment is not revascularizable. It allows better aesthetic and functional results.
