目的 探讨断指再植患者采用微波理疗联合康复训练的影响。方法 回顾性选取2022年1月—2023年12月于福州市第二总医院进行断指再植的患者,采用康复训练的50例患者纳入对照组,采用微波理疗联合康复训练的51例患者纳入观察组,对比两组干预1个月后的毛细血管反应情况、感知恢复情况、疼痛评分、手指功能及日常生活能力情况。结果 干预1个月后, 观察组患指的温度[(28.43±5.86)℃ vs (26.15±5.39)℃,t=2.025,P<0.001]、毛细血管反应[(9.76±2.63)cm/s vs(7.36±2.23)cm/s,t=4.922,P=0.046,]高于对照组(P<0.05);观察组的英国医学研究委员会感觉评分[(15.79±3.75)分 vs(11.88±3.13)分,t=5.660,P<0.001]高于对照组;观察组第2周[(3.72±0.88)分 vs(4.39±0.92)分,t=3.721,P<0.001]、4周后[(2.67±0.32)分 vs(3.03±0.52)分,t=4.169,P=0.001]的视觉模拟量表(VAS)评分低于对照组(P<0.05);观察组的密歇根手功能量表(MHQ)评分[(61.05±10.68)分 vs(52.58±10.21)分,t=4.054,P<0.001]高于对照组(P<0.05);观察组的生活质量综合评定表(GQLI-74)评分[(320.16±55.25)分 vs(270.85±50.06)分,t=4.677,P<0.001]高于对照组(P<0.05);观察组的Barthel指数[(75.71±12.84)分 vs(68.58±12.23)分,t=2.843,P=0.005]高于对照组(P<0.05)。结论 微波理疗联合康复训练能够提高断指再植患者的手指功能,减轻患者疼痛,改善日常生活质量。
Objective To explore the effect of microwave physiotherapy combined with rehabilitation training on finger function and daily living ability of patients with severed finger replantation.Methods Patients who underwent replantation of severed fingers in our hospital from January 2022 to December 2023 were selected retrospectively.Fifty patients who received rehabilitation training were included in the control group,51 patients who were intervened by microwave physiotherapy combined with rehabilitation training were included in the observation group.The blood circulation,sensory recovery,pain score,finger function and daily living ability of the two groups were compared.Results The temperature([28.43±5.86]℃ vs [26.15±5.39]℃,t=2.025,P<0.001) and capillary reaction([9.76±2.63]cm/s vs [7.36±2.23]cm/s,t=4.922,P=0.046) of the affected fingers in the observation group were higher(P<0.05).The sensory score([15.79±3.75] vs [11.88±3.13],t=5.660,P<0.001)of the observation group was higher than that of the control group(P<0.05).The visual analogue scale(VAS)scores of the observation group at the second week([3.72±0.88] vs [4.39±0.92],t=3.721,P<0.001) and four weeks later([2.67±0.32]vs [3.03±0.52],t=4.169,P=0.001)were lower than those of the control group(P<0.05).The score of Michigan Hand Outcome Questionnair(MHQ)([61.05±10.68] vs [52.58±10.21],t=4.054,P<0.001) in the observation group was higher(P<0.05).The GQLI-74 score([320.16±55.25] vs [270.85±50.06]) and Barthel index([75.71±12.84] vs[68.58±12.23],t=2.843,P=0.005)in the observation group were higher(P<0.05).Conclusions Microwave physiotherapy combined with rehabilitation training can improve the finger function,relieve the pain and improve the quality of daily life of patients with severed fingers.
目的 探讨断指再植术后血管危象发生情况及危险因素。方法 收集2015年8月—2016年12月我院行断指再植术患者66例临床资料行回顾性分析,根据患者术后是否发生血管危象分为A组(发生血管危象)和B组(未发生血管危象),收集两组患者一般临床资料,采用单因素和多因素Logistic 回归分析影响断指再植术患者术后血管危象发生的危险因素。结果 单因素分析得出,性别、年龄、吸烟史、指别、外伤原因、末端断离及缺血时间在A、B两组间比较有统计学意义(P<0.05)。多因素分析得出,性别、年龄、吸烟史、指别、外伤类型、末端断离、缺血时间均为影响断指再植术术后血管危象发生危险因素。结论 血管危象为断指再植术常见并发症,影响发生血管危象危险因素较多,临床中应针对性进行预防和干预,以降低断指再植术患者术后血管危象发生率,提高断指存活率。