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论著·临床研究 | 更新时间:2024-10-24
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感觉再教育训练结合镜像疗法对下肢截肢患者幻肢痛的治疗效果
Therapeutic effect of sensory re⁃education training combined with mirror therapy on phantom limb pain in patients with lower limb amputation

广西医学 页码:1361-1365

作者机构:华莉,本科,主管护师,研究方向为骨科护理、护理管理。

基金信息:国家自然科学基金(81702190)

DOI:10.11675/j.issn.0253-4304.2024.09.12

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目的 探讨感觉再教育训练结合镜像疗法对下肢截肢患者幻肢痛的治疗效果。方法 选择60例下肢截肢术后幻肢痛患者作为研究对象,采用随机数字表法将其分为观察组和对照组,每组30例。观察组患者实施感觉再教育训练结合镜像疗法,对照组患者仅实施镜像疗法。治疗前及治疗后1周、3周、6周,比较两组患者下肢截肢的简化的McGill疼痛问卷评分[包括视觉模拟量表(VAS)评分、现时疼痛强度(PPI)评分、疼痛分级指数(PRI)评分]、匹兹堡睡眠质量指数(PSQI)评分和汉密尔顿焦虑量表(HAMA)评分。结果 两组患者的VAS评分、PPI评分、PRI评分、PSQI评分、HAMA评分比较,差异有统计学意义(P<0.05);两组患者的VAS评分、PPI评分、PRI评分、PSQI评分、HAMA评分均有随时间延长而降低的趋势(P<0.05);分组与时间均存在交互效应(P<0.05)。治疗后3周、6周,观察组的VAS评分低于对照组;治疗后1周、3周、6周,观察组PPI评分、PRI评分、PSQI评分、HAMA评分低于对照组(P<0.05)。结论 相较于单纯镜像疗法,应用感觉再教育训练结合镜像疗法更能减轻下肢截肢术后幻肢痛患者的疼痛程度,改善睡眠质量及焦虑状态,值得临床应用推广。

Objective To investigate the therapeutic effect of sensory re⁃education training combined with mirror therapy on phantom limb pain in patients with lower limb amputation. Methods Sixty patients with phantom limb pain after lower limb amputation were selected as the research subjects, and they were divided into observation group or control group according to the random number table method, with 30 cases in each group. Patients of the observation group received sensory re⁃education training combined with mirror therapy for treatment, whereas the control group received only mirror therapy. Short Form of McGill Pain Questionnaire score with respect to Visual Analogue Scale (VAS) score, Present Pain Intensity (PPI) score, and Pain Rating Index (PRI) score, as well as Pittsburgh Sleep Quality Index (PSQI) score, and Hamilton Anxiety Scale (HAMA) score before treatment, and 1, 3, 6 weeks after treatment were compared between the two groups. Results There were statistically significant differences in VAS score, PPI score, PRI score, PSQI score, and HAMA score between the two groups (P<0.05). There was a tendency of decreases in VAS score, PPI score, PRI score, PSQI score, and HAMA score of patients in both groups with the prolonging of time (P<0.05). There was an interaction effect between grouping and time (P<0.05). The observation group exhibited a lower score of VAS 3 and 6 weeks after treatment, and lower scores of PPI, PRI, PSQI, and HAMA 1, 3, 6 weeks after treatment as compared with the control group (P<0.05). Conclusion Compared with single mirror therapy, applying sensory re⁃education training combined with mirror therapy can prominently reduce degree of phantom limb pain in patients after lower extremity amputation, ameliorate their sleep quality and anxiety, which is worthy of application and promotion.

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