倪少俊 徐秋月

[摘要]目的：分析燒伤后手部瘢痕挛缩畸形患者接受修复治疗后的功能恢复情况，并比较不同年龄的恢复差异。方法：以笔者医院2017年1月-2019年12月确诊的74例烧伤后手部瘢痕挛缩畸形患者为研究对象，均接受相同康复治疗包括加压治疗、手指主被动活动、温水治疗、作业疗法，分析康复治疗后功能恢复情况，并分年龄段探讨其恢复情况。结果：本组74例患者在接受康复治疗后1个月手部主动活动与被动活动度、生活自理能力ADL评分均明显大于治疗前，治疗后3个月明显大于治疗前、治疗后1个月，差异有统计学意义（P<0.05）;相同年龄段组内比较，治疗后1、3个月主被动活动度、生活自理能力ADL评分均高于治疗前，且治疗后3个月高于治疗后1个月，差异有统计学意义（P<0.05）;不同年龄段组间比较，41～60岁、61～71岁组治疗后1、3个月主被动活动度、生活自理能力ADL评分均低于24～40岁，且61～71岁组低于41～60岁组，差异有统计学意义（P<0.05）。结论：烧伤后手部瘢痕挛缩畸形患者接受积极的康复治疗可保证功能的有效恢复，且恢复质量与年龄呈正相关，年龄越小的患者恢复速度越快，恢复质量越高。

[关键词]瘢痕;烧伤;手部;挛缩畸形;功能恢复;年龄差异

[中图分类号]R619+.6    [文献标志码]A    [文章编号]1008-6455（2021）04-0089-03

Comparison of Functional Recovery in Different Ages Patients with Hand Burn Scar Contracture Deformity after Repair

NI Shao-jun1，XU Qiu-yue2

[1.Department of Burn Plastic Hand Surgery;2.Operation Room，Fifth Affiliated Hospital （Zhuhai） of Zunyi Medical University，Zhuhai 519100，Guangdong，China]

Abstract： Objective  To analyze the functional recovery of patients with hand scar contracture deformity after burn treatment and compare the age differences. Methods  Seventy-four patients with post-burn scar contracture deformity diagnosed in our hospital from January 2017 to December 2019 were enrolled as subjects. All patients received the same rehabilitation treatment， including pressure treatment， finger active and passive activity， warm water treatment and occupational therapy. The functional recovery after rehabilitation treatment was analyzed， and the recovery was discussed by age. Results  The ADL scores of active and passive hand activity and life self-care ability after 1 month rehabilitation treatment among the patients were significantly greater than before treatment， and were even significantly greater after 3 months treatment， the differences were statistically significant （P<0.05）. Within the same age group， the ADL scores of active and passive activity and life self-care ability at 1 and 3 months after treatment showed to be higher， morever the scores were higher for 3 months than 1 month （P<0.05）. Comparison of different age groups showed us that the patients in 41～60 years old， 61～71 years old group， the ADL scores of life self-care ability was both lower than 24～40 years old group， and 61～71 years old group was lower than the level of 41～60 years old group （P<0.05）. Conclusion  Patients with scar contracture deformities of hands after active burns can receive effective rehabilitation， and the quality of recovery is positively correlated with age. The younger the patients， the faster the recovery speed and the higher the recovery quality.

Keywords： scar; burn; hand; contracture deformity; functional recovery; age difference

手背侧的皮肤松弛且薄，存在大量肌腱、关节以及内在小肌群，因此可进行各类细致、精巧的操作[1]。手部烧伤后容易出现瘢痕增生以及挛缩，并进一步使得关节过伸、屈曲，手部烧伤后轻微患者手功能会减低，严重患者自理能力会完全丧失。随着医学技术的进步，整容修复技术的提升，对这类患者通过开展整复手术可实现手部功能、形态的恢复，但术后完全康复也需要较长时间，术后的康复质量与患者接受的康复治疗情况密切相关[2-3]。以往临床关于烧伤后手部瘢痕挛缩畸形修复后功能恢复的研究有很多[4]，但对于不同年龄患者康复差异的研究不多，基于此，本研究以笔者医院2017年1月-2019年12月74例此类患者为对象，在分析其康复水平的基础上进一步探讨不同年龄患者的康复差异。……