中药浸浴联合功能训练用于儿童手部烧伤康复治疗的临床研究

余方珍; 张建芬; 吴晓霞; 卞卫霞

doi:10.16766/j.cnki.issn.1674-4152.002915

中药浸浴联合功能训练用于儿童手部烧伤康复治疗的临床研究

doi: 10.16766/j.cnki.issn.1674-4152.002915

浙江衢化医院护理部，浙江衢州 324004

基金项目:

浙江省医药卫生科技计划项目 2022KY1350

衢州市科技攻关项目 2022081

详细信息

通讯作者:
张建芬，E-mail: 1063545182@qq.com

中图分类号: R644 R244.9 R473.3
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- 文章访问数: 122
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- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2022-10-19
- 网络出版日期: 2023-04-19

Study on traditional Chinese medicine immersion combined with functional training in the rehabilitation of hand burns in children

Department of Nursing, Quhua Hospital, Quzhou, Zhejiang 324004, China

摘要

摘要: 目的针对手部烧伤患儿采取科学、系统、有效的术后康复理疗措施，对于其整体预后水平的提高至关重要。本研究观察中药浸浴联合功能训练对儿童手部烧伤植皮术后的康复治疗效果。方法选择2019年1月—2022年3月于浙江衢化医院就诊并接受植皮手术治疗的104例手部烧伤患儿为研究对象，使用随机数表法将患儿分为研究组(52例)和对照组(52例)，对照组患儿术后实施压力康复治疗，研究组患儿在此基础上增加中药浸浴联合功能训练。干预前后采用数字评定量表(NRS)、面部表情分级评分(FRS)和温哥华瘢痕量表(VSS)评价患肢瘙痒、疼痛及瘢痕症状程度，比较腕关节背伸活动度、手指关节总主动活动度(TAM)和Jebsen手功能测试时间等患肢运动功能指标变化，评估患肢功能恢复情况。结果干预后，研究组患肢NRS、FRS和VSS评分[(1.49±0.54)分, (1.59±0.62)分，(4.23±0.56)分]低于对照组[(2.16±0.61)分, (2.23±0.73)分，(4.97±0.63)分，均P＜0.05]。干预后，研究组患肢腕关节背伸活动度和TAM[(68.59±4.93)°，(157.84±6.29)°]均显著高于对照组[(57.66±4.85)°，(139.71±6.17)°]，Jebsen手功能测试时间[(6.14±0.75)min]显著短于对照组[(7.23±0.82)min]，均P＜0.05。研究组患肢功能恢复优良率显著高于对照组(P < 0.05)。结论中药浸浴联合功能训练有助于缓解手部烧伤患儿瘙痒、疼痛症状，提高烧伤创面愈合美观程度和患肢运动功能恢复水平。
- 手部烧伤 /
- 儿童 /
- 中药浸浴 /
- 功能训练 /
- 康复治疗
Abstract: Objective It is very important to take scientific, systematic and effective postoperative rehabilitation physiotherapy measures for children with hand burn to improve their overall prognosis. This study aims to observe the rehabilitation treatment of traditional Chinese medicine immersion combined with functional training after skin grafting for children with hand burn. Methods A total of 104 children with hand burns who were treated with skin grafting in Zhejiang Quhua Hospital from January 2019 to March 2022 were taken as the study subjects. The children were divided into research group (52 cases) and control group (52 cases) according to the random number table method. The pressure rehabilitation treatment was carried out for the children in the control group, and on the basis of this, the children in the research group were treated with the addition of traditional Chinese medicine immersion and combined with functional training. The numerical rating scale (NRS), face rating scale (FRS) and Vancouver scar scale (VSS) were used to assess the degree of itch, pain and scar symptoms of the injured limb before and after the intervention. The changes of the exercise function of the injured limb such as wrist dorsiflexion mobility, the time of total action motion (TAM) and Jebsen' s hand function test were compared. The recovery level of the injured limb and the overall health condition of the child were also evaluated. Results After the intervention, the scores of NRS, FRS and VSS in the research group [(1.49±0.54) points, (1.59±0.62) points, (4.23±0.56) points] were significantly lower than those in the control group [(2.16±0.61) points, (2.23±0.73) points, (4.97±0.63) points, all P < 0.05]. After the intervention, the degree of back stretching and TAM of the injured limbs in the research group [(68.59±4.93)°, (157.84±6.29)°] were significantly higher than those in the control group [(57.66±4.85)°, (139.71±6.17)°], while the time of Jebsen' s hand function test [(6.14±0.75) min] was significantly shorter than that of the control group [(7.23±0.82) min], all P < 0.05. The excellent recovery rate of the injured limb in the research group was significantly higher than that in the control group (P < 0.05). Conclusion The combination of traditional Chinese medicine immersion and functional training could relieve the itch and pain of the burned hand, improve the aesthetic level of the burned wound healing, and the recovery of the motor function of the injured limb.
- Hand burn /
- Children /
- Traditional Chinese medicine bath /
- Functional training /
- Rehabilitation therapy

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表 1 2组手部烧伤患儿干预前后患肢NRS、FRS和VSS评分比较(x±s，分)

Table 1. Comparison of NRS, FRS, and VSS scores of affected limbs before and after intervention in children with hand burns in the two groups(x±s, points)

组别	例数	NRS评分		FRS评分		VSS评分
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
研究组	52	3.47±0.72	1.49±0.54^a	5.82±1.13	1.59±0.62^a	7.18±0.84	4.23±0.56^a
对照组	52	3.42±0.69	2.16±0.61^a	5.77±1.16	2.23±0.73^a	7.09±0.81	4.97±0.63^a
t值		0.362	5.931	0.223	4.819	0.556	6.331
P值		0.718	＜0.001	0.824	＜0.001	0.579	＜0.001
注：与同组干预前比较，^aP＜0.05。

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表 2 2组手部烧伤患儿干预前后患肢运动功能指标比较(x±s)

Table 2. Comparison of motor function indexes of the affected limbs of children with hand burns in the two groups before and after intervention(x±s)

组别	例数	腕关节背伸活动度(°)		TAM(°)		Jebsen测试完成时间(min)
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
研究组	52	24.36±2.85	68.59±4.93^a	86.92±4.18	157.84±6.29^a	9.26±1.09	6.14±0.75^a
对照组	52	24.73±2.96	57.66±4.85^a	87.45±4.29	139.71±6.17^a	9.18±1.14	7.23±0.82^a
t值		0.649	11.527	0.638	14.838	0.351	7.628
P值		0.518	＜0.001	0.525	＜0.001	0.690	＜0.001
注：与同组干预前比较，^aP＜0.05。

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表 3 2组手部烧伤患儿干预后患肢功能恢复优良率比较[例(%)]

Table 3. Comparison of excellent and good rates of functional recovery of the affected limb of children with hand burns in the two groups after intervention [cases (%)]

组别	例数	优	良	可	差	总体优良
研究组	52	21(40.38)	25(48.08)	5(9.62)	1(1.92)	46(88.46)
对照组	52	15(28.85)	22(42.31)	11(21.15)	4(7.69)	37(71.15)
注：2组优良率比较，χ²=4.833，P=0.028。

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