综合性康复治疗在儿童手部烧伤患者中应用效果的评估

发布时间：2017-12-27 07:05

本文关键词：综合性康复治疗在儿童手部烧伤患者中应用效果的评估　出处：《宁夏医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的采用随机对照实验的研究方法,对手部烧伤儿童采取不同的康复治疗方法,从而比较不同康复治疗手段的有效性及临床使用价值。研究综合性康复治疗对于儿童手部烧伤治疗的效果,判断其疗效是否优于单组康复治疗方法组,为临床治疗小儿手部烧伤方案的制定提供实验依据。方法本实验根据纳入及排除标准选取2014年1月——2016年1月在甘肃省人民医院及兰州大学第二医院烧伤矫形科住院治疗的手部烧伤患儿作为研究对象,随机分为5组,分别采用普通包扎及加压治疗(A组)、运动治疗(B组)、物理因子治疗(C组)、游戏及心理治疗(D组)、综合性康复治疗(E组)。分别根据治疗后第7天、第14天、第28天后瘙痒评分表、FLACC儿童烧伤疼痛评分表、FACE ladder评分系统对患儿手部创面的瘙痒、疼痛情况进行评分。于治疗后第30天、第60天、第90天依照温哥华瘢痕评分量表(Vancouver scar scale,VSS)、手关节总活动度(TAM)评分表对患儿手部创面瘢痕生长情况及手指关节活动度进行评价。采用对照组(A组)与实验组(B组、C组、D组、E组)数据进行对比,及综合性康复治疗方法(E组)分别与单组康复治疗方法(B组、C组、D组)对比,采用统计学分析方法,评价各康复治疗方法的有效性。结果本实验共收录244例患儿,其中对照组(A组)44例,运动治疗组(B组)54例,物理因子治疗组(C组)49例,游戏及心理治疗组(D组)48例,综合康复治疗组(E组)29例。年龄6.18±3.29岁,男性患儿126例,女性患儿118名。(1)与对照组相比,分别采用运动治疗(B组)、物理因子治疗(C组)、游戏及心理治疗(D组)、综合性康复治疗(E组)的患儿在治疗后第7天、第14天、第28天时瘙痒、疼痛程度均有减轻,且统计结果均具有统计学意义(P0.05)。(2)运动治疗(B组)、物理因子治疗(C组)、综合性康复治疗(E组)组患者于治疗后第30天、第60天、第90天时,瘢痕形成情况与对照组相比具有统计学意义(P0.05)。第30天时三组患儿手指关节活动度的评价无统计学差异(P0.05),而于第60天、第90天时,三组患儿手指关节活动度的评价具有统计学差异(P0.05)。(3)游戏及心理治疗组(D组)患儿于治疗后第30天、第60天、第90天时分别与对照组比较瘢痕形成情况、手指关节活动度评价均无统计学差异(P0.05)。(4)综合性康复治疗组分别与其余三组(B组、C组、D组)进行对比,在治疗后第7天、第14天、第28天时创面瘙痒、疼痛程度无明显差异(P0.05),但于治疗后治疗60天及90天时,其瘢痕形成情况、手指关节活动度的评价均有明显差异,具有统计学意义(P0.05)。结论儿童手部烧伤早期康复锻炼可以促进临床症状的减轻,其中运动治疗、物理因子治疗、游戏及心理治疗、综合性康复治疗对于儿童手部烧伤的早期康复均有一定的作用。游戏及心理治疗对于后期功能锻炼效果较不明显。综合性康复治疗的临床效果较理想,在治疗瘢痕挛缩及瘢痕增生方面效果较为突出。
[Abstract]:Objective to compare the effectiveness and the clinical value of different rehabilitation methods in children with hand burn. Objective to study the effect of comprehensive rehabilitation therapy on children with hand burn, and to determine whether the curative effect is better than that of a single rehabilitation therapy group, so as to provide experimental evidence for the formulation of clinical treatment of pediatric hand burn. Methods according to the inclusion and exclusion criteria from January 2014 to January 2016 of hospitalized children with hand burn in Gansu province people's Hospital and Second Hospital Affiliated to Lanzhou University burn orthopedics as the research object, randomly divided into 5 groups, respectively, using ordinary dressing and compression treatment (A group), exercise therapy (B group), C group (physical therapy), game and psychological therapy (D group) and comprehensive rehabilitation therapy (E group). According to the seventh days, fourteenth days and twenty-eighth days after treatment, itching scale, FLACC pediatric burn pain scale and FACE ladder scoring system were used to score the itching and pain of hand wounds. On the thirtieth day, the sixtieth day and the ninetieth day after treatment, according to the Vancouver scar Rating Scale (Vancouver scar scale, VSS) and the total activity of hand joints (TAM) scale, we evaluated the scar growth and the activity range of the fingers of children. The control group (group A) and the experimental group (B group, C group, D group, E group) data were compared, and the comprehensive rehabilitation therapy group (E group) was compared with the single group rehabilitation therapy group (B group, C group, D group). The effectiveness of the rehabilitation therapy was evaluated by statistical analysis. Results a total of 244 children were included in the experiment, including 44 cases in the control group (group A), 54 cases in the exercise therapy group (group B), 49 cases in the physical factor treatment group (group C), 48 cases in the game and psychotherapy group (group D), and 29 cases in the comprehensive rehabilitation treatment group (E group). The age was 6.18 + 3.29 years old, 126 cases of male children and 118 female children. (1) compared with the control group, respectively with exercise therapy (B group), physical therapy (C group), games and psychological treatment (group D), comprehensive rehabilitation therapy (E group) in the treatment of children after seventh days, fourteenth days and twenty-eighth days of itching, pain were relieved, and the statistical results were statistically significant (P0.05). (2) exercise therapy (group B), physical factor therapy (group C) and comprehensive rehabilitation therapy (group E) had statistically significant difference in scar formation on thirtieth days, sixtieth days and ninetieth days after treatment (P0.05). On the thirtieth day, there was no statistical difference in the activity of finger joints between the three groups (P0.05), but on sixtieth days and ninetieth days, there was a significant difference in the activity of finger joints between the three groups (P0.05). (3) in the thirtieth days, sixtieth days and ninetieth days after treatment, there was no significant difference in scar formation and finger joint activity between the game group and the psychotherapy group (D group) (P0.05). (4) comprehensive rehabilitation treatment group respectively with the other three groups (B group, C group, D group) were compared, seventh days after treatment, fourteenth days and twenty-eighth days were itching, pain degree had no significant difference (P0.05), but after treatment for 60 days and 90 days, the scar formation evaluation, finger joint activity was significantly different, with statistical significance (P0.05). Conclusion early rehabilitation training for children of hand burn can contribute to relieve the clinical symptoms, including exercise therapy, physical therapy, psychological therapy, games and comprehensive rehabilitation therapy has a certain role in the hands of children burn early rehabilitation. The effect of game and psychotherapy on later functional exercise is not obvious. The clinical effect of comprehensive rehabilitation therapy is ideal, and it is more effective in the treatment of scar contracture and scar hyperplasia.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R726.5

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