罂粟碱联合阶段康复对手外伤游离皮瓣移植术后患者应用价值探究  

Application value of papaverine combined with staged rehabilitation in patients after free flap transplantation for hand trauma

作　　者：章月红 蒋春燕 赵学燕 钟素 薛春梅 陈宣辰 ZHANG Yuehong;JIANG Chunyan;ZHAO Xueyan;ZHONG Su;XUE Chunmei;CHEN Xuanchen(Department of Orthopedics,West Lake Hospital Affiliated to Hangzhou Medical College/The 903rd Hospital of the Joint Logistics Support Force of the People's Liberation Army of China,Hangzhou 310014,China;Department of Military Patient Management,West Lake Hospital Affiliated to Hangzhou Medical College/The 903rd Hospital of the Joint Logistics Support Force of the People's Liberation Army of China,Hangzhou 310014,China;Department of Nursing,West Lake Hospital Affiliated to Hangzhou Medical College/The 903rd Hospital of the Joint Logistics Support Force of the People's Liberation Army of China,Hangzhou 310014,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇三医院/杭州医学院附属西湖医院骨科,杭州310014 [2]中国人民解放军联勤保障部队第九〇三医院/杭州医学院附属西湖医院军队伤病员管理科,杭州310014 [3]中国人民解放军联勤保障部队第九〇三医院/杭州医学院附属西湖医院护理部,杭州310014

出　　处：《中国药师》2024年第8期1327-1335,共9页China Pharmacist

基　　金：浙江省教育厅一般科研项目(202249326)。

摘　　要：目的探索罂粟碱联合阶段康复对手外伤游离皮瓣移植术后患者的应用价值。方法回顾性收集2021年1月至2022年1月于中国人民解放军联勤保障部队第九〇三医院接受手外伤术后患者资料,按治疗方法分为联合康复组(罂粟碱联合阶段康复护理)和阶段康复组(仅应用阶段康复护理)。比较两组患者视觉模拟量表(VAS)评分、康复锻炼依从性评分、术后手部皮肤感觉功能优良率、手指总主动活动度(TAM)、Jamar握力、上肢功能评定(DASH)量表评分和血管危象的发生率。结果研究共纳入120例患者,联合康复组57例和阶段康复组63例。两组患者手术前VAS评分、Jamar握力和DASH评分差异无统计学意义(P>0.05);干预14 d及干预3个月时,两组患者的VAS评分较干预前下降(P<0.05),且联合康复组患者VAS评分均显著低于阶段康复组(P<0.05)。干预3个月后,联合康复组患者的康复锻炼依从性评分、手部皮肤感觉功能优良率、手指TAM高于阶段康复组(P<0.05);两组Jamar握力较干预前升高,但联合康复组高于阶段康复组(P<0.05);两组DSAH评分较干预前降低,且联合康复组低于阶段康复组;在干预3个月内,联合康复组患者的血管危象发生率显著低于阶段康复组(P<0.05)。结论罂粟碱联合阶段康复可以有效减轻患者术后疼痛,增强患者的康复锻炼依从性,有效改善术后手部功能及上肢运动功能,并降低了血管危象的发生率。Objective To explore the application value of popaverine combined with stage rehabilitation for patients after free flap grafting for hand trauma.Methods Data of postoperative patients who underwent hand trauma from January 2021 to January 2022 in The 903rd Hospital of the Joint Logistics Support Force of the People's Liberation Army of Chinawere retrospectively collected,and they were divided into the combined rehabilitation group(poppadine combined with stage rehabilitation care)and the stage rehabilitation group(only stage rehabilitation care was applied)according to the treatment methods.Visual analog scale(VAS)scores,rehabilitation exercise adherence scores,postoperative rates of excellent cutaneous sensory function of the hand,total active mobility(TAM)of the fingers,Jamar grip strength,upper extremity functional assessment(DASH)scale scores,and the incidence of vascular crises were compared between the two groups.Results A total of 120 cases were included in the study,with 57 cases in the combined rehabilitation group and 63 cases in the stage rehabilitation group.There was no statistically significant difference in VAS scores,Jamar grip strength and DASH scores between the two groups before surgery(P>0.05);at 14 days and 3 months of intervention,VAS scores of the two groups decreased compared with the pre-intervention period(P<0.05),and VAS scores of the patients in the combined rehabilitation group were significantly lower than those in the stage rehabilitation group(P<0.05).After 3 months of intervention,the rehabilitation exercise adherence score,the rate of excellent hand skin sensory function,and finger TAM of the patients in the combined rehabilitation group were higher than those in the stage rehabilitation group(P<0.05);Jamar grip strength were elevated in both groups compared with the pre-intervention period,but the combined rehabilitation group were higher than those in the stage rehabilitation group(P<0.05);DSAH scores were lower in both groups compared to pre-intervention,and were lower in the

关 键 词：罂粟碱 阶段康复 手外伤 术后康复 游离皮瓣 

分 类 号：R658.2[医药卫生—外科学]