综合康复护理在挤压伤残留足下垂中的应用
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摘要
目的探讨地震挤压伤患者后期残留足下垂的综合康复护理效果。方法对36例残留有足下垂的挤压伤伤员采取心理干预,物理疗法、功能训练、手法康复护理、支具佩戴等综合康复方法,长期随访观察36例患者的踝及脚趾功能恢复情况,根据Mariland足部评分标准对其康复护理效果进行评定。结果综合康复护理后随访12～24个月,36例患者均取得了满意的康复护理效果,踝及脚趾的背伸功能明显改善,行走功能恢复正常。按照Mariland足部评分标准:由综合康复护理前的(52.0±8.8)分上升至12个月后的(85.5±9.6)分和24个月后的(88.6±9.1)分,差异有统计学意义(P<0.01);其中优28例,良6例,可2例,差0例,总体优良率为94.4%。结论由于地震这种自然灾害的特殊性,在地震中受挤压伤的伤员因挤压时间过长,后期可能残留不同程度的肢体感觉运动功能障碍,应当重视长期观察伤员患肢的功能恢复情况;经临床护理实践综合康复护理对挤压伤残留足下垂的患者疗效显著。
Objective To explore nursing effect of comprehensive rehabilitation in the earthquake late foot crush injuries patients remain drooping. Methods 36 cases with enough residual drooping extrusion injuries were taken heart intervention, physical therapy, function training, technique, a treatment with comprehensive rehabilitation method to wear, and long-term follow-up 36 cases of the injured ankle and toe the function recovery, according to Mariland foot rating criteria of outcomes were assessed.Results After comprehensive rehabilitation nursing follow-up of 12 to 24 months, 36 patients with the wounded achieved satisfactory therapeutic effect, ankle and toe back out the function improved obviously, walking function back to normal. According to Mariland foot score standard: a comprehensive rehabilitation before treatment (52.0±8.8)scores up to 6 months after the (85.5±9.6)scores and 12 months after (88.6±9.1)scores, P<0.01; optimal in 28 cases good in 6 cases, could be in 2 cases, poor in 0 case, overall rate was 94.4%. Conclusion Because of the earthquake the particularity of the injury, the late crush injuries that may remain different degree of body feeling motor dysfunction, attention shall be paid to the long-term observation of the body function; Comprehensive rehabilitation care scheme to keep patients to disable extrusion sagging curative effect is distinct.
Objective To explore nursing effect of comprehensive rehabilitation in the earthquake late foot crush injuries patients remain drooping. Methods 36 cases with enough residual drooping extrusion injuries were taken heart intervention, physical therapy, function training, technique, a treatment with comprehensive rehabilitation method to wear, and long-term follow-up 36 cases of the injured ankle and toe the function recovery, according to Mariland foot rating criteria of outcomes were assessed.Results After comprehensive rehabilitation nursing follow-up of 12 to 24 months, 36 patients with the wounded achieved satisfactory therapeutic effect, ankle and toe back out the function improved obviously, walking function back to normal. According to Mariland foot score standard: a comprehensive rehabilitation before treatment (52.0±8.8)scores up to 6 months after the (85.5±9.6)scores and 12 months after (88.6±9.1)scores, P<0.01; optimal in 28 cases good in 6 cases, could be in 2 cases, poor in 0 case, overall rate was 94.4%. Conclusion Because of the earthquake the particularity of the injury, the late crush injuries that may remain different degree of body feeling motor dysfunction, attention shall be paid to the long-term observation of the body function; Comprehensive rehabilitation care scheme to keep patients to disable extrusion sagging curative effect is distinct.
引文
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[2]刘沙鑫,雷中杰,付平,等.地震挤压伤后多系统损害的早期康复治疗介入1例报告[J].中国康复医学杂志,2011,26(3):281-283.
[3]刘守国,励建安,艾金飞,等.四川省北川中学地震伤员康复状况调查分析[J].中国康复医学杂志,2009,24(8):680-683.
[4]MueMatsu K,Ihara K,Kuwabara Y,et al.Surgical correction of claw toe deformity following harvesting of fibula flaps[J].Ann Plast Surg,2010,65(2):161-163.
[5]Tosun B,Akansel G,Sarlak AY.Traumatic dislocation of the fist metatarsophalangeal joint with entrapment of the flexor hallucis longus tendon[J].J Foot Ankle Surg,2008,47(4):357-361.
[6]伍晓靖,王跃,卢冰,等.汶川大地震挤压伤伤员伤情特点及干预措施[J].实用医院临床杂志,2010,7(1):27-28.
[7]齐颖.坐骨神经损伤手术病人的功能锻炼[J].护理研究,2010,24(1):62-63.
[8]楚海波,和瑞欣,郭锐,等.踝足矫形器及针灸对偏瘫患者足内翻、足下垂步行能力的影响[J].中国实用神经疾病杂志,2010,21(13):57.
[9]张申申,王磊,郭卫中.踝关节扭伤致腓总神经损伤原因分析与诊治[J].实用手外科杂志,2012,26(2):159-160.
[10]钟卫江.电针治疗腓总神经损伤22例[J].浙江中西医结合杂志,2012,22(9):741.
[11]刘瑞莲,谢军,屈红林.运动医学领域周围神经损伤研究的特点与进展[J].中国组织工程研究与临床,2009,41(13):8151-8154.
[12]蒋协远,王大伟.骨科临床疗效评价标准[M].北京:人民卫生出版社,2005:241-243.
[13]赵振彪,彭彦辉.骨科康复医学[M].石家庄:河北科学技术出版社,2008:216-219.
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