自制三维打印助餐辅具与传统万能袖带助餐辅具在烧伤后上肢功能障碍患者中的效果对比

罗皓; 陈佩; 谢卫国

doi:10.3760/cma.j.cn501120-20220103-00004

自制三维打印助餐辅具与传统万能袖带助餐辅具在烧伤后上肢功能障碍患者中的效果对比

doi: 10.3760/cma.j.cn501120-20220103-00004

武汉大学同仁医院暨武汉市第三医院烧伤科，武汉　　430060

基金项目:

重大疾病防治科技行动计划创伤修复专项 2018-ZX-01S-001

湖北省卫生健康委员会科研项目 WJ2019M003

武汉市卫生和健康委员会科研项目 WG19B02

武汉市卫生和计划生育委员会科研项目 WG18Q10

详细信息

通讯作者:
谢卫国，Email：wgxie@hotmail.com

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出版历程
- 收稿日期: 2022-01-03

Comparison of the effects of self-made three-dimensional printed assistant tableware and traditional universal cuff assistant tableware in patients with upper limb dysfunction after burn injury

Department of Burns, Tongren Hospital of Wuhan UniversityWuhan Third Hospital, Wuhan 430060, China

Funds:

Special Trauma Repair Program of Scientific and Technological Action Plan for Treatment and Prevention of Serious Diseases 2018-ZX-01S-001

Scientific Research Project of Health Commission of Hubei Province of China WJ2019M003

Scientific Research Project of Health Commission of Wuhan WG19B02

Scientific Research Project of Wuhan Municipal Health and Family Planning Commission WG18Q10

More Information

Corresponding author: Xie Weiguo, Email: wgxie@hotmail.com

摘要

摘要: 目的对比自制三维打印助餐辅具（以下简称三维辅具）与传统万能袖带助餐辅具（以下简称万能袖带）对烧伤后上肢功能障碍患者自主进食功能的影响。方法采用前瞻性自身对照研究方法。2020年3月—2021年6月，武汉大学同仁医院暨武汉市第三医院收治18例符合入选标准的中重度烧伤后上肢功能障碍患者，其中男15例、女3例，年龄21~58（42±11）岁。使用三维软件及三维打印机为患者定制三维辅具后，指导患者在连续14 d内分别隔天使用三维辅具和万能袖带进食各7 d，其间也可无辅具由他人喂食。统计患者使用每种辅具进食正餐次数及其占所属7 d内进食正餐总次数的比例；使用2种辅具共14 d后（以下简称使用14 d后），测量患者使用2种辅具的转移液体用时和转移液体量，评定患者在无辅具、使用三维辅具、使用万能袖带时改良Barthel指数（MBI）中进食项的评分，采用利克特5级量表评价患者在无辅具、使用三维辅具、使用万能袖带时的进食主观满意度。对数据行配对样本t检验、Wilcoxon符号秩和检验、χ²检验。结果患者使用三维辅具的7 d中进食正餐次数为（18.1±2.0）次，明显多于使用万能袖带的（4.0±2.0）次（t=53.72，P<0.01）。患者使用三维辅具进食正餐次数占所属7 d内进食正餐总次数的比例为72.4%（325/449），明显高于使用万能袖带的16.7%（72/431），χ²=257.36，P<0.01。使用14 d后，患者使用三维辅具转移液体用时、转移液体量分别明显短于、多于使用万能袖带（t值分别为2.49、7.52，P<0.05或P<0.01）；患者使用三维辅具时MBI中进食项评分与使用万能袖带的评分相近（P>0.05），且均明显高于无辅具时的评分（Z值分别为3.90、3.86，P<0.01）；患者使用三维辅具的进食满意度评分与使用万能袖带评分相近（P>0.05），且均明显高于无辅具时的评分（Z值分别为3.61、3.00，P<0.01）。结论三维辅具和万能袖带都可代偿烧伤后上肢功能障碍患者肢体功能，提高其自主进食能力，但三维辅具在提高患者进食意愿及转移食物效率方面更具优势。
- 烧伤 /
- 康复 /
- 打印，三维 /
- 日常生活活动 /
- 自助装置
Abstract: Objective To compare the effects of self-made three-dimensional (3D) printed assistant tableware (hereinafter referred to as 3D assistive device) and traditional universal cuff assistant tableware (hereinafter referred to as universal cuff) on the voluntary eating function of patients with upper limb dysfunction after burns. Methods The prospective self-control study was conducted. From March 2020 to June 2021, 18 patients with upper limb dysfunction after moderate to severe burns who met the inclusion criteria were admitted to Tongren Hospital of Wuhan University & Wuhan Third Hospital, including 15 males and 3 females, aged 21-58 (42±11) years. After using the 3D software and 3D printer to customize 3D assistive devices for patients, the patients were instructed to eat with the 3D assistive devices and the universal cuff on alternate days for 14 consecutive days, each for 7 days. During this time, the patients could also be fed by someone else without using the assistive device. The number of times the patients ate regular meals with each assistive device and the proportion of them to the total number of regular meals ate during the 7 days to which they belonged were counted. After the total use of two assistive devices for 14 days (hereinafter referred to as after use of 14 days), the amount and time of transferring liquid using the two assistive devices of patients were measured; the patients' feeding items in the modified Barthel index (MBI) were scored respectively when eating without the assistive device, with the 3D assistive device, or with the universal cuff; the satisfaction degree of feeding when eating without the assistive device, with the 3D assistive device, or with the universal cuff was evaluated using the 5-grade Likert scale. Data were statistically analyzed with paired sample t test, Wilcoxon signed rank sum test, and chi-square test. Results The number of the patients ate regular meals with the 3D assistive device during the 7 days was (18.1±2.0) times, which was significantly more than (4.0±2.0) times with the universal cuff (t=53.72, P<0.01). The proportion of the number of the patients ate regular meals with the 3D assistive device to the total number of regular meals ate during the 7 days to which it belonged was 72.4% (325/449), which was significantly higher than 16.7% (72/431) with the universal cuff (χ²=257.36, P<0.01). After use of 14 days, the patients' time and amount of transferring liquid using the 3D assistive device were respectively significantly shorter and more than using the universal cuff (with t values of 2.49 and 7.52, respectively, P<0.05 or P<0.01). The patients' MBI feeding scores when eating with the 3D assistive device and with the universal cuff were close (P>0.05), which were both significantly higher than the score when eating without the assistive device (with Z values of 3.90 and 3.86, respectively, P<0.01).The patients' satisfaction scores of feeding when eating with the 3D assistive device and with the universal cuff were close (P>0.05), which were both significantly higher than the score when eating without the assistive device (with Z values of 3.61 and 3.00, respectively, P<0.01). Conclusions Both the 3D assistive device and the universal cuff can compensate the limb function of patients with upper limb dysfunction after burns and improve their self-feeding ability, but the 3D assistive device has more advantages in improving patients' willingness to eat and the efficiency of food transfer.
- Burns /
- Rehabilitation /
- Printing, three-dimensional /
- Activities of daily living /
- Self-help devices
罗皓：试验方案制订、实施，数据采集、整理、分析，论文撰写；陈佩：数据采集，论文修改；谢卫国：研究指导，论文修改，经费支持

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1 自制三维打印助餐辅具设计图与成品图。1A.设计图；1B.成品图

注：图1A中1指示握把，2指示延长杆，3指示餐具固定腔

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2 烧伤后上肢功能障碍患者使用自制三维打印助餐辅具转移液体测试。2A.患者舀出桌面碗中的液体；2B.患者将舀起的液体转移到置物架上的碗中

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3 烧伤后上肢功能障碍患者佩戴自制三维打印助餐辅具。3A.手正位；3B.手侧位

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