早期运动对指V区屈肌腱损伤伴尺神经损伤修复术后患者手部功能的影响  

Passive mobilization for restoring hand function after surgical flexor tendon and ulnar nerve repair

作　　者：黄琴[1] 高春华[3] 陈燕花[2] 刘莉[1] 吴中文[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院康复科,武汉430022 [2]华中科技大学同济医学院附属协和医院手外科 [3]华中科技大学同济医学院附属同济医院康复科

出　　处：《中华物理医学与康复杂志》2015年第9期686-689,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的探讨早期运动对指V区屈肌腱损伤伴尺神经损伤修复术后患者手部功能的影响。方法选取指V区屈肌腱损伤伴尺神经损伤修复术后患者53例，按照随机数字表法将其分为观察组（26例、88指）和对照组（27例、91指）。术后给予2组患者常规治疗；术后4周时，2组患者开始进行主被动活动训练，观察组在此基础上于术后第8天开始进行早期运动。术后第12周，采用总主动活动度（TAM）测定法、周围神经感觉功能评价及肩臂手残疾问卷（DASH）对2组患者的手部功能进行评定，记录患者的腕关节主动活动度及握力。结果术后第12周时，观察组TAM明显优于对照组，差异有统计学意义（P〈0．05）。与对照组比较，观察组在腕关节掌屈、背伸、尺偏、桡偏4种状态下的主动活动度[（56．08±11．05）°、（49．31±9．67）°、（32．50±8．10）°、（23．65±6．34）°]较为优异，差异有统计学意义（P〈0．05）。术后第12周时，观察组握力百分比、神经修复后手功能及DASH值均优于对照组，差异有统计学意义（P〈0．05）。结论早期运动可促进指V区屈肌腱损伤伴尺神经损伤修复术后患者的手部功能恢复，有效提高患者对患手功能恢复的满意度，值得临床府阳椎广．Objective To explore the effects of early active mobilization on hand function after zone 5 flexor tendon and ulnar nerve repair. Methods Fifty-five patients who had received primary repair in zone 5 of a flexor tendon and the ulnar nerve were randomly divided into an observation group （26 cases, 88 digits） and a control group （27 cases, 91 digits）. Both groups were given routine treatment after the operation, and started to do active and pas- sive exercise 4 weeks later. The observation group was additionally forced to do active range of motion exercise train- ing starting 8 clays after the operation. Twelve weeks after the operation, the hand function of both groups was as- sessed using the total active motion （TAM） scoring system of the American Society for Surgery of the Hand, peripher- al nerve function evaluation and the disabilities of arm-shoulder-hand （DASH） scale. Results At the end of the treatment, the average TAM score of the observation group was significantly better than that of the control group. The average active movement range of the wrist in palm flexion, dorsal extension, ulnar deviation and in radial deviation were all significantly better than in the control group. Grip strength, overall hand function and DASH score were also significantly better on average. Conclusion Early active mobilization following flexor tendon and ulnar nerve repair can effectively promote the recovery of hand function.

关 键 词：屈肌腱修复 尺神经 康复 主动活动 

分 类 号：R473.6[医药卫生—护理学]