手掌侧烧伤后瘢痕挛缩的治疗方案研究  

Study on Treatment of Scar Contracture after Palm Side Burn

作　　者：梁锋[1] 陈昴[1] 王红[1] 

机构地区：[1]陕西省汉中市中心医院美容整形科,陕西汉中723000

出　　处：《医学临床研究》2016年第3期537-538,542,共3页Journal of Clinical Research

摘　　要：【目的】研究手掌侧烧伤后瘢痕孪缩的治疗方案。【方法】选择2012年1月至2015年6月在本院就诊的80例手掌侧烧伤后瘢痕孪缩患者，按照随机数表法将患者分为观察组和对照组，每组各40例，对照组患者由康复师对其手部挛缩关节和瘢痕进行被动运动治疗，观察组患者采用掌骨指骨牵引矫治法，对两组患者的瘢痕情况、关节总活动度（TAM）、日常生活活动能力（ADL）进行评定，记录两组患者的不良反应率。【结果】治疗后，观察组瘢痕评分明显低于对照组，TAM评分、ADL评分明显较对照组高，差异均具有统计学意义（均P〈0．05）；观察组患者不良反应率为7．5％，与对照组患者5％的不良反应率比较差异无统计学意义（P〉0．05）；观察组患者复发率为0．0％（0／40）与对照组10．0％（4／40）比较差异具有统计学意义（P〈0．05）。【结论】掌骨指骨牵引能够有效治疗手掌侧烧伤后瘢痕挛缩，能够极大程度地提高患者关节活动度，缓解瘢痕挛缩，有助于患者手部功能的恢复，降低术后复发率。[Objective] To study the treatment of scar contracture after palm side burn. [Methods]Eight cases of burn scar contracture patients were selected from January 2012 to June 2015 in the hospital. The patients were randomly divided into study group and control group, 40 people in each group. Patients in the control group were treated on the hand joint contracture and scar of passive motion therapy by rehabilitation division, while patients of the study group with metacarpal and phalangeal traction therapy. The scar scores, the total activity of joint （TAM）, activities of daily living （ADL） of two groups of patients were assessed , and the rate of the adverse reactions of two groups were recorded. [Results]After the treatment, the scar score of the study group was significantly lower than that of the control group. The score of the total score, the score of daily living activity of the study group were significantly higher than that of the control group （ P 〈0.05）. The adverse reaction rate of the study group was 7.5%, the difference was not statistically significant （ P 〉0.05）, and the recurrence rate of the study group was 0.0% （0/40）, significantly lower than the control group 10% （4/40）（ P 〈0.05）. [Conclusion] Metacarpal and phalangeal traction is effective in the treatment of burn scar contracture, and can greatly improve joint activities, alleviate the scar contracture, help in the recovery of hand function of patients and reduce the postoperative recurrence rate.

关 键 词：烧伤/并发症 手掌 瘢痕/病因学 挛缩/治疗 掌骨 指骨 

分 类 号：R644[医药卫生—外科学]