急诊手外伤术后肌腱粘连原因分析与早期防治策略.docVIP

急诊手外伤术后肌腱粘连原因分析与早期防治策略 　　【摘要】 目的：探讨急诊手外伤术后肌腱粘连的原因分析与早期防治策略效果。方法：2011年1月-2012年12月来笔者所在医院急诊就诊的手外伤患者120例为对照组，术后发生肌腱粘连48例，通过回顾性分析主要原因。观察组患者针对分析的主要原因，对2013年1月-2014年12月手外伤患者102例，进行早期防治的处理，观察术后肌腱粘连的情况，并于术后第8周评价两组患者的手部肌腱总主动活动度。结果：对照组患者术后肌腱粘连48例，占比例为40.0%，根据急诊就诊情况、伤情特点、受伤原因及治疗情况进行回顾性分析。主要原因为：清创不彻底，肌腱吻合不当，损伤正常的肌腱及吻合后期处理不当，遗漏损伤肌腱，肌腱与皮肤瘢痕粘连及患者心理影响等。观察组患者采用早期防治策略，发生肌腱粘连19例占18.6%，两组患者术后手部肌腱总主动活动度观察组明显优于对照组，两者比较差异有统计学意义（P0.05）。结论：根据急诊手外伤术后肌腱粘连的原因进行早期防治策略，可有效地减少肌腱粘连的发生，减轻和避免手外伤肌腱损伤后手功能的丧失。 　　【关键词】 手外伤； 肌腱粘连； 原因； 防治 　　中图分类号 R473 文献标识码 B 文章编号 1674-6805（2015）20-0014-03 　　Analysis of the Causes of Emergency Hand Trauma Postoperative Tendon Adhesion and Early Prevention Strategy/ZHANG Jian-sheng，YANG Ri-xin，ZHU Jing-feng，et al.//Chinese and Foreign Medical Research，2015，13（20）：14-16 　　【Abstract】 Objective： To investigate the emergency hand trauma after analysis of the causes of tendon adhesion and early prevention strategy effect. Method： 120 patients with hand injury control group in 2011 January to 2012 December in our hospital emergency department visits cases， 48 cases occurred postoperative tendon adhesion. By reviewing the main reason analysis. The observation group based on the analysis of main reasons， from 2013 January to 2014 December， 102 patients with hand injury were treated， early prevention， observation of postoperative tendon adhesion， and in eighth weeks after the operation， evaluation of two groups of patients with hand tendon total active motion. Result： In the control group， the postoperative tendon adhesion in 48 cases， accounted for 40%， according to the hospital emergency room visits， injury characteristics， causes and treatment were retrospectively analyzed， the main reason was incomplete debridement， improper tendon anastomosis， injury of normal tendon and anastomosis of improper treatment after missing injured tendons， tendon and skin scar and patients psychological impact. The observation group were treated with early prevention strategies， had tendon ad