早期超短波联合序贯压力治疗对手深度烧伤后功能恢复的作用  

Effects of early treatment with ultrashort wave combined with sequential pressure on functional recovery of deeply burned hands

作　　者：石梦娜[1] 李娜[1] 王冰水[1] 易南[1] 粱艳艳[1] 朱婵[1] 党瑞[1] 胡大海[1] 

机构地区：[1]第四军医大学西京医院全军烧伤中心,烧伤与皮肤外科,西安710032

出　　处：《中华烧伤杂志》2014年第6期472-476,共5页Chinese Journal of Burns

摘　　要：目的 研究手深度烧伤创面愈合后早期进行超短波联合序贯压力治疗,对患手功能恢复的影响. 方法 2012年7月-2013年6月,笔者单位收治65例单侧手部深Ⅱ～Ⅲ度烧伤患者.创面基本愈合后10～31 d,根据患者意愿35例患者进行主动运动、超短波、序贯压力治疗以及佩戴压力手套,设为综合治疗组;另30例患者仅行主动运动训练及佩戴压力手套,设为常规治疗组.治疗前及治疗4周后,观察患手外观,测量患手拇指、示指、中指根部及掌横纹、腕横纹处周径了解患手肿胀情况,采用Carroll上肢功能评定标准对患手功能进行评分及评级.对数据行t检验及秩和检验.结果 （1）治疗4周后,综合治疗组30只患手外形较治疗前改善并接近正常对侧手外观,5只患手出现掌指关节与指间关节挛缩畸形;常规治疗组17只患手外观较治疗前无明显变化,13只患手出现掌指关节过伸、指间关节屈曲及拇指内收畸形.（2）治疗4周后,综合治疗组患手拇指、示指、中指根部及掌横纹、腕横纹处周径较治疗前显著缩短（t值为3.26 ～ 4.24,P值均小于0.01）,常规治疗组患手拇指、中指根部及腕横纹处周径较治疗前显著缩短（t值为2.02 ～ 2.44,P值均小于0.05）.综合治疗组治疗前后患手拇指、示指、中指根部及掌横纹、腕横纹处周径差值分别为（0.491 ±0.022）、（0.583±0.089）、（0.486±0.021）、（1.100±0.076）、（0.751±0.053） cm,明显高于常规治疗组的（0.306±0.021）、（0.277±0.022）、（0.320±0.027）、（0.700±0.052）、（0.483 ±0.048）em（t值分别为5.94、3.11、5.02、4.22、3.68,P值均小于0.01）.（3）治疗4周后,综合治疗组与常规治疗组患手功能评分较治疗前显著增高（t值分别为14.40、4.00,P值均小于0.001）,功能评级较治疗前显著提高（u值分别为6.93、3.29,P值均小于0.01）.综合治疗组治疗前后患手功能评分差值为（51.1±2.2）分,�Objective To study the effects of ultrashort wave combined with sequential pressure treatment on the functional recovery of deeply burned hands in the early stage of healed wounds in hands.Methods Sixty-five patients with burn of unilateral hand were hospitalized from July 2012 to June 2013 in our center.Injured hands of 35 patients were treated with active movement,ultrashort wave,sequential pres sure therapy,and pressure gloves,and the other 30 patients were treated with active movement and pressure gloves 10-31 days after the wounds were healed according to the will of patients.The former 35 patients were regarded as comprehensive treatment （CT） group,and the latter 30 patients were regarded as routine treatment （RT） group.Before treatment and 4 weeks after treatment,the appearance of injured hands was observed; the circumference of the proximal segment of thumb,index,and middle fingers and that of the palmar crease and wrist crease were measured to evaluate swelling of injured hand ; score and grade of function of injured hands were evaluated with a Carroll Upper Extremity Functional Test.Data were processed with t test and rank sum test.Results （1） Four weeks after treatment,appearance of 30 injured hands in group CT was improved,which was close to that of the normal hand of each patient,while contracture deformity of metacarpophalangeal joints and interphalangeal joints was observed in the other 5 injured hands.Four weeks after treatment,no obvious change in the appearance of 17 injured hands in group RT was observed compared with that before treatment,while hyperextension of metacarpophalangeal joints,flexion of interphalangeal joints,and adduction deformity of thumb were observed in the other 13 hands.（2） Four weeks after treatment,the circumferential values of the proximal segment of thumb,index,and middle fingers and the palmar crease and wrist crease of injured hands in group CT were respectively lower than those before treatment （with t values 3.26-4.24,P values below 0.01）,and the

关 键 词：烧伤 手 功能恢复 压力治疗 超短波 

分 类 号：R644[医药卫生—外科学]