三维扫描定制压力袜结合康复训练对老年患者下肢水肿的疗效观察

关键词：三维扫描  压力袜  下肢水肿  关节活动  舒适性

Keywords:three dimensions scanning  gradient compression stockings  edema of the lower extremities  joint motion  comfort sensation

摘要：

      摘要 目的：评价三维扫描定制压力袜、传统市售医用压力袜在老年下肢水肿患者中的康复疗效。 方法：将60例老年下肢水肿患者按随机数字表分为观察组和对照组，每组30例，两组患者均予常规康复治疗（包括手法牵拉肌肉、向心性肢体按摩、无痛范围内关节活动等训练）。对照组在常规康复基础上患肢穿戴市售批量生产传统医用压力袜，观察组在常规康复基础上穿戴三维扫描定制梯级压力袜，每天均穿戴16h。于治疗前、治疗3d、7d、14d、28d时分别采用圆桶溢水测量法测患肢下肢体积、采用Biomaster评估系统测关节活动度、语义差异标尺法评测压力舒适性。 结果：①观察组在治疗7d、14d、28d时患肢体积减少值与对照组相比有明显差异（P<0.01），观察组随治疗时间延长患肢体积减少值依次增加（P<0.05），对照组不同治疗时间点间无明显差异（P>0.05）；②观察组在治疗7d、14d、28d时患肢踝关节被动背屈活动度增加值与对照组相比有明显差异（P<0.05—0.001），观察组在治疗14d、28d时患肢踝关节被动跖屈活动度增加差值与对照组相比有明显差异（P<0.001），观察组随治疗时间延长患肢踝关节背屈和跖屈被动活动度增加值依次升高（P<0.001），对照组不同治疗时间点间无明显差异（P>0.05）；③观察组在治疗7d、14d、28d时压迫感评分明显高于对照组（P<0.05），在治疗3d、7d、14d、28d时舒适感评分高于对照组（P<0.001）。对照组随治疗时间延长压迫感和舒适度均依次降低（P<0.05），观察组不同时间点间无明显差异（P>0.05）。 结论：三维扫描定制梯级压力袜能持续作用于水肿肢体，减轻下肢水肿的同时改善关节活动度，舒适安全有效。

Abstract:

      Abstract Objective: To investigate if gradient compression stockings custom made with three dimensions scanning would be more effective in volume reduction and physical efficacy compared with conventional medical compression stockings. Method: Sixty eldly patients with lower limb edema were randomly assigned into 2 groups. The observation group (n=30) wore gradient compression stockings with three dimensions scanning. The control group (n=30) wore conventional market medical compression stockings. The two groups both wore stockings for 16 hours per day and received conventional physical therapy 60 min daily for 4 weeks. The measurement of lower extremities volume and range of joint motion before and 3, 7 , 14, 28 days after treatment. Pressure comfort was assessed with semantic differential method. Result: 7, 14 and 28 days during the treatment, the volume of leg decreased and ankle range of motion increased gradually (P<0.05, P<0.001), and different from the control group at every time point (P<0.01, P<0.001). The above indexes did not change at every time point (P>0.05) for the control group. The score of comfortable sensation and oppressing sensation was significantly higher in the observation group than in the control group（P<0.001）and did not change within the course. With treatment time increasing, the score of comfortable sensation increased and oppressing sensation reduced in the control group（P<0.001）. Conclusion: Custom-made gradient compression stockings with three dimensions scanning can persistently reduce limb edema. Furthermore, it effectively helps to improve joint motion and comfort.