基于微信指导下的居家镜像治疗应用于下肢截肢后幻肢痛的疗效观察  

Effects of home-based mirror therapy under the guidance of the clinician by Wechat in treatment for phantom limb pain after lower limb amputation

作　　者：肖艳英[1] 秦秀男 常业恬[1] 王亚平[1] XIAO Yanying;QIN Xiunan;CHANG Yetian(The Anesthesiology Department of the Second Xiangya Hospital of Central South University,Changsha,Hunan,410011)

机构地区：[1]中南大学湘雅二医院麻醉科,湖南省长沙市410011

出　　处：《中国康复医学杂志》2022年第4期476-481,493,共7页Chinese Journal of Rehabilitation Medicine

基　　金：湖南省残疾人联合会康复科研项目(2019xk009);湖南省科技计划项目(湖南省自然科学基金2018JJ3769)。

摘　　要：目的:观察微信指导下的居家镜像治疗应用于下肢截肢后幻肢痛的临床效果。方法:将符合纳入标准的下肢截肢后幻肢痛患者50例,随机分为观察组(25例)与对照组(25例)。对照组于治疗室进行镜像治疗,观察组在临床医师微信指导下进行居家镜像治疗训练。两组于治疗前、治疗4周后分别采用简化McGill疼痛问卷(SF-MPQ)评估患者疼痛程度,包含疼痛分级指数(PRI)、视觉模拟疼痛评分(VAS)及现时疼痛强度(PPI)三个内容;采用匹兹堡睡眠质量指数量表(PSQI)评估患者睡眠质量;汉密尔顿焦虑量表(HAMA)评估焦虑情况;于治疗结束后比较两组治疗日均消耗时间与日均花费金钱。结果:与治疗前比较,观察组与对照组在治疗后PRI、VAS、PPI、PSQI与HAMA得分均有所降低,差异有显著性意义(P<0.05);但是两组之间比较差异无显著性意义(P>0.05);治疗后观察组日均消耗时间与日均花费金钱较对照组明显减少,差异有显著性意义(P<0.05)。结论:通过微信指导进行居家镜像治疗下肢截肢后幻肢痛,可以减轻疼痛,提高睡眠质量,改善焦虑情绪,与诊室治疗效果相似。而且患者消耗时间与经济花费更低,更加有利于保持幻肢痛患者进行康复的持续性。Objective:To observe the effect of home-based mirror therapy under the guidance of the clinician by Wechat on phantom limb pain after lower limb amputation.Method:Fifty patients with phantom limb pain after lower limb amputation were randomly assigned into observation group(n=25)and control group(n=25).The control group received mirror therapy in the treatment room,and the observation group received home-based mirror therapy under the guidance of clinician by Wechat.Short form of McGill pain questionnaire(SF-MPQ)was used to evaluate the pain degree at the base time and four weeks after treatment,including pain rating index(PRI),visual analog pain score(VAS)and present pain intensity(PPI).Pittsburgh sleep quality index(PSQI)was used to evaluate sleep quality,and Hamilton anxiety scale(HAMA)was used to evaluate anxiety.At the end of the treatment,the average time cost and average money cost of the two groups were compared.Result:Compared with the baseline,the scores of PRI,VAS,PPI,PSQI and HAMA in the observation group and the control group decreased significantly after treatment(P<0.05),but there was no significant differ-ence between the two groups(P>0.05).After treatment,the average time cost and average money cost in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:Home-based mirror therapy under the guidance of the clinician by Wechat can relieve pain,improve sleep quality and anxiety,which is similar to that of the treatment in the clinic.And patients spend less time and money on the treatment,which is more conducive to maintain the continuity of rehabilitation of patients with phantom limb pain.

关 键 词：幻肢痛 截肢 镜像疗法 居家康复 远程康复 

分 类 号：R683.2[医药卫生—骨科学] R493[医药卫生—外科学]