医院-家庭康复模式在四肢烧伤后瘢痕挛缩患者中的应用效果  

Application effect of hospital-home rehabilitation mode in patients with cicatricial contracture after limbs burn

作　　者：胡丹[1] 顾黎军[1] 邵燕[1] 张雯雯 高燕飞 HU Dan;GU Lijun;SHAO Yan;ZHANG Wenwen;GAO Yanfei(Department of Burn Plastic Surgery,The Third Affiliated Hospital of Nanjing Medical University(Changzhou Second People's Hospital),Changzhou,Jiangsu 213000,China)

机构地区：[1]南京医科大学第三附属医院(常州市第二人民医院)烧伤整形科,江苏常州213000

出　　处：《手术电子杂志》2024年第4期66-70,共5页Electronic Journal of Medical Operations

基　　金：国家青年自然科学基金(82202446)

摘　　要：目的 观察医院-家庭康复模式在四肢烧伤后瘢痕挛缩患者中的应用效果。方法 前瞻性地选取2022年3月—2023年3月常州市第二人民医院收治的50例四肢烧伤后瘢痕挛缩患者作为研究对象,按照数字随机表法随机分成对照组(实施常规康复模式,n=25)和观察组(实施医院-家庭康复模式,n=25)。比较瘢痕情况[温哥华瘢痕量表(VSS)]、心理弹性(CDRISC)、生活质量(SF-36量表)及满意度情况。结果 两组患者VSS评分组间比较、随着时间变化的趋势、时间与组别之间交互作用均有差异(F组别=50.861、F时点=263.014、F交互=9.115,P<0.05)。观察组干预后CDRISC量表坚韧、乐观、自强维度评分高于对照组(t=3.327、2.993、2.927,P<0.05),观察组干预前后CDRISC量表各维度差值高于对照组(t=2.428、3.644、2.695,P<0.05),差异均有统计学意义。两组患者干预后社会功能、躯体功能、角色功能、认知功能均高于干预前(t=-11.522、-13.074、-8.714、-7.830、-7.477、-5.860、-5.379、-3.704,P<0.05);干预后观察组SF-36评分的各维度评分均高于对照组(t=4.408、5.602、3.903、4.308,P<0.05)。结论 医院-家庭康复模式用于四肢烧伤后瘢痕挛缩患者中可改善瘢痕情况,并提高心理弹性水平、提升生活质量。Objective To observe the effect of hospital-home rehabilitation mode in patients with cicatricial contracture after limbs burn.Methods 50 patients with cicatricial contracture after burn of limbs admitted to the Department of Burn Plastic Surgery,The Second People's Hospital of Changzhou,from March 2022to March 2023 were prospectively selected as research subjects,and randomly divided into control group(routine rehabilitation mode,n=25)and observation group(hospital-home rehabilitation mode,n=25)according to the numerical random table method.Scar condition(VSS),psychological resilience(CDRISC scale),quality of life(SF-36scale)and satisfaction were compared.Results There were differences in the inter-group comparison of VSS,the trend over time,and the interaction between time and groups between the two groups(group F=50.861,time point F=263.014,and interaction F=9.115,P<0.05).After intervention,the CDRISC scores of resilience,optimism and self-reliance in the observation group were higher than those in the control group(t=3.327,2.993,2.927,P<0.05),and the differences of those CDRISC scores before and after intervention in the observation group were higher than those in the control group(t=2.428,3.644,2.695,P<0.05).After intervention,the social function,physical function,role function and cognitive function in both groups were higher than those before intervention(t=-11.522,-13.074,-8.714,-7.830,-7.477,-5.860,-5.379,-3.704,P<0.05).After intervention,the SF-36 scores in the observation group were higher than those in the control group(t=4.408,5.602,3.903,4.308,P<0.05).Conclusions Hospital-home rehabilitation mode can improve scar condition,mental resilience and quality of life in patients with cicatricial contracture after limbs burn.

关 键 词：四肢烧伤 康复模式 瘢痕挛缩 效果 生活质量 

分 类 号：R47[医药卫生—护理学]