个体化、量化康复训练对屈指肌腱吻合术后功能恢复的影响  

Individualized and quantified rehabilitation training after tenosuture of the digital flexor tendon

作　　者：王修文[1] 牛瑞[1] 孙强三[2] 吴东进[1] 赵序利[3] 

机构地区：[1]山东大学第二医院骨科,济南250033 [2]山东大学第二医院康复医学科,济南250033 [3]山东省立医院疼痛科

出　　处：《中华物理医学与康复杂志》2009年第5期323-326,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的探讨个体化、量化康复训练对屈指肌腱吻合术后功能恢复的影响。方法将180例屈指肌腱吻合术患者随机分为量化组及对照组。量化组患者在术中测量所吻合肌腱的最大抗张强度（Fmax），术中安装训练支具，测量吻合术后肌腱两断端分离达到2mm间隙时的橡皮筋长度及载荷，并加装保护装置，术后给予个体化、量化康复训练。对照组患者术中未进行肌腱最大抗张强度测定，术后康复训练时亦无特殊保护装置，由患者自行训练手指活动功能。为进一步研究康复训练频率对疗效的影响，将量化组及对照组分别细分为A，B两亚组，分别给予每天3次（A组）、每天6次（B组）康复训练。结果经3个月训练后，发现量化组术后无肌腱断离者，对照组有6例患者发生肌腱再断离，量化组优良率达91．1％，对照组优良率为80．0％，组间差异具有统计学意义（P〈0．05）；进一步分析发现，量化B组患者康复疗效明显优于其它亚组，组间差异均有统计学意义（P〈0．05）。结论个体化、量化康复训练能有效防止肌腱吻合术后患者肌腱再断离，且每天训练6次可能是较佳康复治疗频率。Objective To evaluate the effect of individualized and quantified rehabilitation exercise after tenosuture of the digital flexor tendon. Methods One hundred and eighty cases of digital flexor tendon tenosuture were randomly divided into a quantification group and a control group. For the quantification group, the maximal tensile strength against rupture （ Fmax ） was measured during the operation. After splinting, the length of an elastic band was measured when there was a 2 mm clearance between the 2 ends of the sutured tendon, and the protective device was then fixed with all its parameters unchanged in the whole study. For the control group, Fmax was not measured and there was no protective device during training. Both groups were subdivided into subgroups A and B according to the daily training frequency. Training frequencies of 3 or 6 times per day were applied to the two subgroups. Results After 3 months of rehabilitation treatment, there was no re-rupture in the quantification group, but 6 cases of re-rup- ture occurred in the control group. 91% of the cases in the quantification group were evaluated as excellent or good, while in the control group 80% of the cases were evaluated as excellent or good. Clinical efficacy was significantly better in the quantification subgroup receiving 6 treatments per day than in any other subgroup. Conclusions Individualized and quantified rehabilitation exercise can prevent tendon re-rupture after tenosuture. 6 sessions of training per day may be better than 3 sessions per day.

关 键 词：肌腱损伤 支具 康复 功能恢复 

分 类 号：R687.2[医药卫生—骨科学]