王旭 夏斯曼 邹仕波 崔正军

[摘要]目的：探讨儿童手烧伤瘢痕畸形植皮修复术后矫形器联合综合康复手段在儿童手功能康复中的应用效果。方法：选择2016年5月-2019年3月笔者科室收治的符合纳入标准的患儿60例，分为实验组（n=30）和对照组（n=30）。对照组采用综合康复手段（运动疗法联合压力治疗），在康复治疗师指导下进行手功能康复训练，佩戴量身定制压力手套。实验组在对照组基础上进行矫形器佩戴。在治疗前、治疗后3个月，两组分别采用温哥华瘢痕评分量表、手指总关节活动度、Jebsen手功能测试、Barthel指数对患儿的瘢痕、运动功能、手功能及日常生活活动能力进行评价。结果：治疗后，实验组在瘢痕情况、运动功能、手功能及日常生活活动能力方面改善情况均优于对照组，差异均有统计学意义（P<0.05）。结论：矫形器联合综合康复手段在儿童手烧伤瘢痕畸形植皮修复术后能够改善运动功能、手功能，提高日常生活活动能力。

[关键词]瘢痕畸形;烧伤;儿童;手功能;压力治疗;矫形器

[中图分类号]R619+.6    [文献标志码]A    [文章编号]1008-6455（2021）05-0041-04

Application Effect of Orthosis in Hand Function Rehabilitation after Skin Grafting Repair of Hand Burn Scar Deformity in Children

WANG Xu，XIA Si-man，ZOU Shi-bo，CUI Zheng-jun

（Department of Burn and Reconstruction Surgery，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450000，Henan，China）

Abstract： Objective  To investigate the application effect of orthosis combined with comprehensive rehabilitation in the rehabilitation of children's hand function. Methods  60 cases of children admitted to our department from May 2016 to March 2019 who met the inclusion criteria were selected and divided into the experimental group （n=30） and the control group （n=30）.The control group was treated with comprehensive rehabilitation （physical therapy and pressure therapy）， hand function rehabilitation training was conducted under the guidance of rehabilitation therapists， and wore pressure gloves. The experimental group wore orthoses on the basis of the control group. Before and three months after treatment， the two groups used the Vancouver scar score scale， total finger motion， Jebsen hand function test and Barthel index to evaluate the scar， motor function， hand function and daily living ability of the children. Results  After treatment， the scar condition， motor function， hand function and activities of daily living in the experimental group were better than those in the control group， and the differences were statistically significant （P<0.05）. Conclusion  Orthosis combined with comprehensive rehabilitation can improve the motor function， hand function and activities of daily living in children with hand burn scar deformity after skin grafting..

Key words： scar deformity; burn; children; hand function; stress therapy; orthosis

燒伤是造成儿童意外伤害的主要原因之一，每年烧伤儿童约为300～500万。手为暴露部位，在遇到火焰燃烧时，致伤几率较高[1]。深度手部烧伤可导致手挛缩畸形，丧失功能，影响儿童生长发育，造成儿童身心功能障碍。烧伤治疗采用多学科协作的工作模式，康复医学是烧伤后期功能恢复阶段重要的一环，多项研究表明早期综合康复手段能促进烧伤后功能恢复，提高患者日常生活活动能力[2-3]。儿童由于其处于生长发育阶段，生长速度快，自身调节能力较差，与成人相比烧伤后瘢痕增生速度快，周期长。……