体外冲击波疗法在恢复烧伤所致神经损伤和增生性疤痕患者手部功能方面的临床效用:一项前瞻性、随机、双盲研究。

IF 12.5 2区 医学 Q1 SURGERY International journal of surgery Pub Date : 2024-10-01 DOI:10.1097/JS9.0000000000002103
Seung Yeol Lee, Yoon Soo Cho, Cheong Hoon Seo, Jisu Seo, So Young Joo
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引用次数: 0

摘要

背景:手部烧伤后常见关节挛缩和神经损伤。体外冲击波疗法(ESWT)不仅能有效促进包括瘢痕组织在内的各种组织的再生,还能减轻烧伤患者的疼痛和瘙痒。研究人员试图探索 ESWT 对烧伤后神经损伤引起的手部功能障碍的影响:我们评估了 ESWT(与假刺激相比)对神经损伤和增生性疤痕手部的影响,以及对手部功能的影响。本研究是一项双盲随机对照试验,共有 120 名患者参与。ESWT 的参数如下:能量通量密度为 0.05-0.30 mJ/mm2;频率为 4 Hz;每次治疗 1000 到 3000 个脉冲;治疗 12 次,每周一次,持续 12 周。结果测量如下10 分疼痛视觉模拟量表、捷布森-泰勒手部功能测试、握力、普渡佩格板测试、超声波测量疤痕厚度以及治疗前和治疗 12 周后的皮肤特征:初步评估后,组间差异不明显(P>0.05)。在 VAS 评分(P=0.004)、手部关节伸展 ROM(P=0.02)、JTT 评分(书写、小和轻)(PConclusion)方面,ESWT 组比假体组有更明显的改善:我们确定了 ESWT 在促进手部功能、改善瘢痕和减轻瘢痕相关疼痛方面的临床有益效果,从而凸显了 ESWT 在改善烧伤后因神经损伤和增生性瘢痕而受损的手部功能方面的优势。
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Clinical utility of extracorporeal shock wave therapy in restoring hand function of patients with nerve injury and hypertrophic scars due to burns: A prospective, randomized, double-blinded study.

Background: Joint contractures and nerve injuries are common after hand burns. Extracorporeal shock wave therapy (ESWT) is effective not only for the regeneration of various tissues, including scar tissues, but also for reducing pain and pruritus in patients with burns. Researchers have attempted to explore the effects of ESWT on hand dysfunction caused by nerve injury following burns.

Materials and methods: We evaluated the effects of ESWT (compared to sham stimulation) on hands with nerve injury and hypertrophic scars and thereby on hand function. The current study was a double-blind randomized controlled trial involving 120 patients. The ESWT parameters were as follows: energy flux density, 0.05-0.30 mJ/mm2; frequency, 4 Hz; 1000 to 3000 impulses per treatment; and 12 treatments, one/week for 12 weeks. Outcome measures were as follows: 10-point visual analog scale for pain, Jebsen-Taylor hand function test, grip strength, Purdue Pegboard test, ultrasound measurement of scar thickness, and skin characteristics before and immediately after 12 weeks of treatment.

Results: No significant inter-group difference was noted after the initial evaluation (P>0.05). More significant improvements were found in the ESWT group than in the sham group in terms of the VAS score (P=0.004), extension ROMs of hand joints (P=0.02), the JTT scores (writing, small, and light) (P<0.001, P<0.001, and P=0.002), and skin characteristics (melanin, skin distensibility, and biologic skin elasticity) (P=0.004, P<0.001, and P<0.001). Other measured outcomes did not differ between the two groups after the treatment.

Conclusion: We identified the clinically beneficial effects of ESWT in promoting hand function, improving scarring, and alleviating scarring-related pain, thereby highlighting its advantages in improving hand function that has been impaired due to nerve injury and hypertrophic scars after burns.

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来源期刊
CiteScore
17.70
自引率
3.30%
发文量
0
审稿时长
6-12 weeks
期刊介绍: The International Journal of Surgery (IJS) has a broad scope, encompassing all surgical specialties. Its primary objective is to facilitate the exchange of crucial ideas and lines of thought between and across these specialties.By doing so, the journal aims to counter the growing trend of increasing sub-specialization, which can result in "tunnel-vision" and the isolation of significant surgical advancements within specific specialties.
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