渐进式关节康复训练对深Ⅱ度烧伤修复术后瘢痕挛缩畸形的矫治效果研究

王学萍 张婷渟

[摘要]目的：探究漸进式关节康复训练活动对深Ⅱ度烧伤修复术后瘢痕挛缩畸形的矫治效果，为患者的临床治疗提供参考。方法：回顾性分析笔者医院2016年8月-2018年8月行深Ⅱ度烧伤修复术后瘢痕挛缩患者120例的诊疗情况。按照患者治疗方式的不同，将其均分为观察组和对照组，各60例。对照组给予常规四肢主动被动活动、加压治疗及温水治疗，观察组在对照组的基础上联合渐进式关节康复训练，分析两组患者术后矫治效果、疼痛评分、关节活动度以及生活能力。结果：观察组治疗总有效率为95.0%，明显高于对照组的88.3%，差异有统计学意义（P<0.05）。治疗前观察组疼痛评分与对照组比较差异无统计学意义（P>0.05）;治疗后，观察组疼痛评分明显低于对照组，差异具有统计学意义（P<0.05）。治疗后，观察组患者主动关节活动度与被动关节活动度均明显高于对照组，差异具有统计学意义（P<0.05）;且观察组生活能力评分明显高于对照组，差异具有统计学意义（P<0.05）。结论：渐进式关节康复训练活动有助于减轻患者术后四肢疼痛，改善患者关节功能，提高矫治效果，值得在临床治疗中广泛推广。

[关键词]烧伤;深Ⅱ度;康复训练;渐进式;瘢痕挛缩;矫正;治疗效果;预后

[中图分类号]R644 R619.6   [文献标志码]A    [文章编号]1008-6455（2019）07-0076-03

The Effect of Progressive Joint Rehabilitation Training on the Correction of Scar Contracture Deformity after Deep Second Degree Burn Repair

WANG Xue-ping，ZHANG Ting-ting

（Department of Rehabilitation Medicine，West China Hospital，Sichuan University，Chengdu 611130，Sichuan，China）

Abstract： Objective  To explore the effect of progressive joint rehabilitation training on the correction of scar contracture deformity after deep second degree burn repair， and provide reference for clinical treatment of patients. Methods  A retrospective analysis was made on the diagnosis and treatment of 120 patients with scar contracture after deep second degree burn repair in our hospital from August 2016 to August 2018. According to the different treatment methods， the patients were divided into the observation group and the control group， 60 cases in each group. The patients in the control group were given routine active and passive limb movement， pressure therapy and warm water treatment. The patients in the observation group were combined with progressive joint rehabilitation training on the basis of the control group. The corrective effect， pain score， joint activity and life ability of the two groups were analyzed. Results  The total effective rate of the observation group was 95.0%， which was significantly higher than that of the control group （88.3%）， the difference was statistically significant（P<0.05）. There was no significant difference in pain score between the observation group and the control group before treatment（P>0.05）. After treatment， the pain score in the observation group was significantly lower than that in the control group（P<0.05）. After treatment， the active joint activity and passive joint activity in the observation group were significantly higher than those in the control group （P<0.05）. And the living ability score of observation group was significantly higher than that of control group（P<0.05）. Conclusion  Progressive joint rehabilitation training activities can help alleviate postoperative limb pain， improve joint function and improve the curative effect， and it is worthy of widespread promotion in clinical treatment.

Key words： burn; deep Ⅱ degree; rehabilitation training; progressive; scar contracture; correction; therapeutic effect; prognosis

深Ⅱ度燒伤是指患者由于火焰、高温固体、化学物资或强辐射热所引起的组织损伤。患者在临床上表现为皮肤水疱，并且水疱底部呈红色或白色，其中充满了清澈、粘稠的液体，触痛敏感，受到压迫时变白，这种情况下患者真皮层受到损伤但仍有真皮层残留[1-2]。……