【摘要】：目的：觀察赤木洗劑治療指屈肌腱修復(fù)術(shù)后粘連的臨床療效。方法：依據(jù)納入及排除標(biāo)準(zhǔn),本研究收集2014年12月至2015年09月在實(shí)習(xí)醫(yī)院骨手顯微外科門診和住院就診的需行指屈肌腱修復(fù)術(shù)的患者40例,根據(jù)隨機(jī)對(duì)照原則平均分為試驗(yàn)組和對(duì)照組,其中試驗(yàn)組20人,對(duì)照組20人。兩組均給予早期清創(chuàng),采用改良Kessller肌腱縫合法行肌腱修復(fù)手術(shù)并石膏外固定,術(shù)后給予消腫抗炎、改善循環(huán)等對(duì)癥治療,術(shù)后4周兩組均拆除石膏,試驗(yàn)組傷肢局部行中藥熏洗并配合主被動(dòng)功能鍛煉,2周為1個(gè)療程,連續(xù)2個(gè)療程。對(duì)照組除熏洗時(shí)水液內(nèi)不放中藥外,其它均與試驗(yàn)組相同。治療4周后兩組均隨訪4周。于術(shù)后第4、第8和第12周分別測(cè)量患者傷指掌指關(guān)節(jié)(MP)、近側(cè)指間關(guān)節(jié)(PIP)、遠(yuǎn)側(cè)指間關(guān)節(jié)(DIP)主動(dòng)屈曲度數(shù),伸直受限度數(shù)及傷指腫脹消退情況,并進(jìn)行疼痛評(píng)分。統(tǒng)計(jì)分析將采用SPSS 20.0統(tǒng)計(jì)分析軟件進(jìn)行計(jì)算。所有數(shù)據(jù)采用均數(shù)±標(biāo)準(zhǔn)差(X±S)進(jìn)行描述,所有的統(tǒng)計(jì)檢驗(yàn)均采用雙側(cè)t檢驗(yàn)或秩和檢驗(yàn)或χ2檢驗(yàn)；P值≤0.05將被認(rèn)為所檢驗(yàn)的差別有統(tǒng)計(jì)學(xué)意義。結(jié)果：通過對(duì)一般資料進(jìn)行分析,試驗(yàn)組和對(duì)照組在性別、年齡、損傷區(qū)域等方面均無明顯差異(P0.05)。治療4周后以及4周隨訪期結(jié)束后,兩組患指總主活動(dòng)度均有明顯恢復(fù),試驗(yàn)組明顯優(yōu)于對(duì)照組,且兩組具有顯著性差異(P0.05)；試驗(yàn)組患指功能活動(dòng)評(píng)定優(yōu)良率分別為70%、63.3%,而對(duì)照組患指功能活動(dòng)評(píng)定優(yōu)良率分別為35.7%、28.6%,試驗(yàn)組明顯高于對(duì)照組,且兩組具有顯著性差異(P0.05)；傷指腫脹消退個(gè)數(shù)和疼痛評(píng)分兩組間也存在明顯差異(P0.05),說明試驗(yàn)組腫脹、疼痛等癥狀改善情況較對(duì)照組明顯。整個(gè)試驗(yàn)過程中兩組均無不良事件產(chǎn)生。結(jié)論：赤木洗劑熏洗外用療法能顯著增加患指總主活動(dòng)度,提升指功能活動(dòng)評(píng)定優(yōu)良率,以及改善患指疼痛及腫脹程度,是治療指屈肌腱修復(fù)術(shù)后粘連的一種方便、有效、安全的療法。
[Abstract]:Objective: to observe the clinical effect of Chimu lotion in repairing postoperative adhesions of flexor digitorum tendon. Methods: according to the criteria of inclusion and exclusion, 40 patients with flexor digitorum tendon repair were collected from December 2014 to September 2015 in the outpatient and inpatient department of bone and hand microsurgery in practical hospital. According to the principle of random control, the experimental group and control group were divided into two groups: the experimental group (20) and the control group (20). Both groups were treated with early debridement, tendon repair with modified Kessller tendon suture and external plaster fixation. The patients in both groups were treated with anti-inflammatory and anti-inflammatory treatment, improving circulation and other symptomatic treatment. The gypsum was removed in both groups at 4 weeks after operation. The experimental group was treated with traditional Chinese medicine fumigation and active and passive function exercise, 2 weeks as a course of treatment and 2 consecutive courses of treatment. The control group was the same as the experimental group except that the traditional Chinese medicine was not put in the water during fumigation and washing. After 4 weeks of treatment, both groups were followed up for 4 weeks. At the 4th, 8th and 12th week after operation, the active flexion degree of (DIP) in the distal interphalangeal joint of the (MP), proximal interphalangeal joint of the injured metacarpophalangeal joint, the degree of limited extension and the swelling of the injured finger were measured, respectively. Pain scores were also scored. The statistical analysis will be calculated by SPSS 20.0 statistical analysis software. All data were described by mean 鹵standard deviation (X 鹵S) and all statistical tests were performed by bilateral t test or rank sum test or 蠂 2 test. Results: there was no significant difference in sex, age and injury area between the experimental group and the control group by analyzing the general data (P0.05). After 4 weeks of treatment and the end of the follow-up period of 4 weeks, the total main activity of the affected fingers in the two groups recovered significantly, and the experimental group was significantly better than the control group, and there was significant difference between the two groups (P0.05). The excellent and good rate of functional activity assessment of affected fingers in the test group was 70 and 63.3, respectively, while that in the control group was 35.728. 6, which was significantly higher than that in the control group. There was significant difference between the two groups (P0.05). There were also significant differences between the two groups (P0.05), indicating that the symptoms of swelling and pain in the experimental group were better than those in the control group. There were no adverse events in both groups during the whole trial. Conclusion: the fumigation and external application of Chimu lotion can significantly increase the total main motion of the affected fingers, improve the rate of functional activity evaluation of the affected fingers, and improve the pain and swelling of the affected fingers. It is a convenient and effective method for the treatment of adhesions of flexor digitorum tendon after repair. A safe cure.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R274.9

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1 穆衛(wèi)強(qiáng);赤木洗劑治療指屈肌腱修復(fù)術(shù)后粘連的臨床療效觀察[D];福建中醫(yī)藥大學(xué);2016年

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本文編號(hào)：2302311