低频脉冲电联合目标导向性康复路径在肱骨干骨折合并桡神经损伤术后康复中的应用  

Application of low-frequency pulse electrotherapy combined with target-oriented rehabilitation path in the postoperative rehabilitation of humeral shaft fracture combined with radial nerve injury

作　　者：王丽娜[1] 史达 杜雷飞 谭翼 张利娟 WANG Li-na;SHI Da;DU Lei-fei;TAN Yi;ZHANG Li-juan(Osteoarthritis Ward,Rehabilitation Hospital of Honghui Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710054,Shaanxi,CHINA;Neurospinal Ward,Rehabilitation Hospital of Honghui Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710054,Shaanxi,CHINA)

机构地区：[1]西安交通大学附属红会医院康复医院骨关节病区,陕西西安710054 [2]西安交通大学附属红会医院康复医院神经脊柱病区,陕西西安710054

出　　处：《海南医学》2023年第6期787-791,共5页Hainan Medical Journal

基　　金：陕西省自然科学基础研究项目(编号:S2021-JC-YB-2604)。

摘　　要：目的研究低频脉冲电联合目标导向性康复路径在肱骨干骨折合并桡神经损伤术后康复中的应用效果。方法选取2018年8月至2021年8月期间西安交通大学附属红会康复医院骨关节病区接诊的86例肱骨干骨折合并桡神经损伤切开复位内固定术术后患者进行研究。按随机数表法分为研究组和对照组各43例。对照组患者采用目标导向性康复路径治疗,研究组患者在对照组治疗的基础上联合低频脉冲电治疗仪治疗。两组患者均治疗6个月,治疗6个月后比较两组患者治疗后的神经功能优良率、治疗前后的指总伸肌、腕伸肌肌力恢复的肌电图(EMG)指标、运动神经传导速度(MCV)、波幅,以及骨折愈合时间和并发症发生率。结果研究组患者的神经功能优良率为86.05%,明显高于对照组的55.81%,差异有统计学意义(P<0.05);治疗前,两组患者的指总伸肌、腕伸肌肌力恢复EMG指标比较差异均无统计学意义(P>0.05),治疗后,研究组患者的指总伸肌、腕伸肌肌力恢复EMG指标明显升高,且研究组患者的指总伸肌、腕伸肌肌力恢复EMG指标分别为224.62±51.30、125.32±12.05,明显高于对照组的182.62±52.41、100.26±9.84,差异均有统计学意义(P<0.05);治疗前,两组患者的MCV、波幅比较差异均无统计学意义(P>0.05),治疗后,两组患者的MCV、波幅明显升高,且研究组患者的MCV、波幅分别为(62.56±2.37)m/s、(19.26±3.38)mV,明显高于对照组的(49.28±3.42)m/s、(15.24±2.62)mV,差异均有统计学意义(P<0.05);研究组患者的骨折愈合时间为(68.56±6.23)d,明显短于对照组的(78.64±6.34)d,差异有统计学意义(P<0.05);研究组患者的并发症发生率为4.65%,略低于对照组的9.30%,但差异无统计学意义(P>0.05)。结论低频脉冲电治疗仪治疗肱骨干骨折合并桡神经损伤切开复位内固定术术后患者,能有效地促进患者骨折的愈合与神经功能的恢复,改善指总伸肌、腕伸肌肌力Objective To study the effect of low-frequency pulse electrotherapy combined with target-oriented rehabilitation path in the postoperative rehabilitation of humeral shaft fracture combined with radial nerve injury.Methods Eighty-six patients with humeral shaft fracture combined with radial nerve injury after open reduction and internal fixation from August 2018 to August 2021 were selected for study.According to the method of random number table,they were divided into study group and control group,each with 43 cases.The patients in the control group were treated with target-oriented rehabilitation path,and the patients in the study group were treated with low-frequency pulse electrotherapy instrument on the basis of the treatment in the control group.Both groups of patients were treated for 6 months.After 6 months of treatment,the excellent and good rate of nerve function,electromyography(EMG)indexes,motor nerve conduction velocity(MCV),amplitude,fracture healing time,and complication rate of extensor digitorum communis and extensor carpi before and after treatment were compared between the two groups.Results The excellent and good rate of neurological function in the study group was 86.05%,which was significantly higher than 55.81%in the control group(P<0.05).Before treatment,there was no statistically significant difference between the two groups in EMG indexes of extensor digitorum communis and extensor carpi muscle strength recovery(P>0.05);after treatment,EMG indexes of extensor digitorum communis and extensor carpi muscle strength recovery in the study group were significantly higher,and the indexes in the study group were 224.62±51.30 and 125.32±12.05,which were significantly higher than 182.62±52.41 and 100.26±9.84 in the control group;the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference between the two groups in terms of MCV and amplitude(P>0.05);after treatment,the MCV and amplitude of the two groups were significantly higher,and t

关 键 词：肱骨干骨折 桡神经损伤 目标导向性康复路径 低频脉冲电治疗仪 神经功能 并发症 

分 类 号：R683.41[医药卫生—骨科学]