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作 者:李旭红[1] 张长杰[2] 范晔[2] 李彦[2] 刘丽君[2]
机构地区:[1]中南大学湘雅三医院康复医学科,长沙410013 [2]中南大学湘雅二医院康复医学科
出 处:《中华物理医学与康复杂志》2004年第11期661-664,共4页Chinese Journal of Physical Medicine and Rehabilitation
摘 要:目的探讨超声治疗对Ⅱ区指屈肌腱损伤修复术后手功能的影响。方法将38例(84指)患者随机分为A、B、C三组。A组12例(28指)进行超声治疗和功能训练;B组11例(28指)给予功能训练(同A组)和假超声治疗;C组15例(28指)仅给予术后常规处理。术后进行TAM评定、手指运动功能损伤及Carroll上肢功能评定。结果第4周末,A组与B组的3项指标的差异均有统计学意义(P<0.05),A组与C组、B组与C组之间差异也有统计学意义(P<0.01)。第12周末时,所测的3项指标,A组、B组和C组之间差异有统计学意义(P<0.01),而A组与B组间差异无统计学意义(P>0.05)。结论Ⅱ区指屈肌腱修复术后,在功能训练的基础上,早期使用超声治疗,对消炎消肿、减轻粘连形成和改善手功能有显著的疗效。Objective To evaluate the efficacy of ultrasound therapy and functional training in the treatment of flexor tendon repair in zone Ⅱ. Methods Thirty eight patients (84 digits) with injured flexor tendons in zone Ⅱ repaired with a modified Kessler suture were randomly divided into 3 groups. In each group, a different postoperative therapy was administered respectively. In group A, exercise training using splintage was conducted since the first day after emergency operation, ultrasound was applied once every day for 2 weeks. In group B the intervention was the same as in group A except that the ultrasound therapy was sham. In group C, instruction of rehabilitation exercise was given in addition to splintage. At the end of the 4th and the 12th week, functional capacity of the involved fingers were evaluated by total activity measurement (TAM), Carroll function evaluation of upper limb and digit function impairment measurements. Results The results showed that, at the end of the 4th week, the variables of TAM and Carroll function evaluation of upper limb in groups A and B were significantly better than that in group C ( P <0.01), the digit function impairment measurements were lower than those in group C, the variables among the groups were significantly different ( P <0.05). At the end of the 12th week, TAM, Carroll and digit function measurements in groups A and B were significantly better than those in group C( P <0.01), yet no statistically significant difference was revealed between groups A and B ( P >0.05). Conclusion The results indicate that ultrasound therapy is effective in improving digital range of motion and digital function after flexor tendon repair in zone Ⅱ in the early stage when used in combination with functional training. Ultrasound is no more beneficial than sham ultrasound in the outcome. Comprehensive function training can significantly improve results after flexor tendon repair.
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