腕手功能位矫形器配合手法淋巴引流治疗脑卒中患者偏瘫上肢水肿的临床研究  

Clinical Study on the Treatment of Hemiplegic Upper Limb Edema in Stroke Patients by Using Functional Wrist-hand Orthosis with Manual Lymphatic Drainage

作　　者：李豪 黄臻 杨文 吴泽弟 Li Hao;Huang Zhen;Yang Wen(Panyu District Central Hospital,Guangzhou,Guangdong,511400,China)

机构地区：[1]广州市番禺区中心医院,广东广州511400

出　　处：《黑龙江医学》2023年第24期3022-3024,共3页Heilongjiang Medical Journal

基　　金：广州市卫生健康科技一般引导项目(20221A010085)。

摘　　要：目的:探讨应用腕手功能位矫形器配合手法淋巴引流(MLD)治疗脑卒中患者偏瘫上肢水肿的疗效。方法:选取2021年3月—2022年1月广州市番禺区中心医院康复医学科收治的符合神经内科标准脑卒中偏瘫伴上肢肿胀的72例患者作为研究对象,采用随机数表法分为观察组和对照组,每组各36例。观察组患者采用常规康复治疗结合腕手功能位矫形器配合MLD技术,患者在接受完MLD技术后佩戴腕手功能位矫形器;对照组患者在常规康复治疗后对患侧上肢气压治疗并进行上肢良肢位摆放宣教。治疗前后分别用疼痛视觉模拟评分法(VAS)、肿胀评估(排水法)、食指关节被动活动度(TPM)和Fugl-Meyer上肢运动功能评分(FMA)对两组患者的疼痛程度、肿胀程度、活动范围和上肢运动功能进行评定。结果:两组患者上肢肿胀程度、疼痛、手指活动范围以及上肢运动功能均有改善,其中观察组患者上肢肿胀程度较对照组显著改善,差异有统计学意义(t=18.364,P<0.05);观察组患者上肢手指活动范围较对照组显著改善,差异有统计学意义(t=17.012,P<0.05);观察组患者上肢运动功能较对照组显著改善,差异有统计学意义(t=16.312,P<0.05);两组患者治疗后疼痛减轻程度相当,差异无统计学意义(t=0.684,P>0.05)。结论:腕手功能位矫形器配合MLD治疗对于脑卒中患者偏瘫上肢肿胀有明显的临床疗效,能明显减轻患侧上肢的水肿程度、缓解疼痛、增加手指活动范围以及上肢运动功能。Objective:To investigate the efficacy of using a functional wrist-hand position orthosis with manual lymphatic drainage(MLD)in the treatment of hemiplegic upper limb edema in stroke patients.Methods:72 patients admitted to the hospital from March 2021 to January 2022 who met the neurological criteria for stroke hemiplegia with upper limb swelling were selected for the study and were divided into observation group and control group using the random number table method,with 36 cases in each group.In the observation group,conventional rehabilitation therapy was combined with functional wrist-hand orthosis treatment with MLD technique,and patients wore a functional wrist-hand orthosis after receiving MLD technique.The control group was treated with pneumatic compression of the affected upper limb after conventional rehabilitation therapy and educated on the placement of good upper limb positions.Visual analog scale(VAS),swelling assessment(drainage method),passive mobility of the index finger joint(TPM)and Fugl-Meyer upper extremity motor function score(FMA)were used to assess pain,swelling level,range of motion and upper extremity motor function in both groups before and after treatment.Results:The degree of upper limb swelling,pain,finger range of motion,and upper limb motor function improved in both groups,with the degree of upper limb swelling significantly improved in the observation group compared with the control group,and the difference was statistically significant(t=18.364,P<0.05).Finger range of motion of the upper extremity was significantly improved in the observation group compared with the control group,and the difference was statistically significant(t=17.012,P<0.05).The upper limb motor function was significantly improved in the observation group compared with the control group,and the difference was statistically significant(t=16.312,P<0.05).There was no statistically significant difference in the degree of pain reduction between the two groups after treatment(t=0.684,P>0.05).Conclusion:A functional

关 键 词：脑卒中 上肢水肿 功能位矫形器 手法淋巴引流 

分 类 号：R651.1[医药卫生—外科学]