Shieh S J, Chiu H Y, Hsu H Y
Department of Surgery, National Cheng-Kung University Hospital, Tainan, Taiwan, Republic of China.
Microsurgery. 1998;18(5):334-6. doi: 10.1002/(sici)1098-2752(1998)18:5<334::aid-micr7>3.0.co;2-n.
The long-term maintenance of sensory gain following sensory reeducation is still unknown for replanted digits. Ten patients with 18 replanted or revascularized digits, who had received a formal sensory reeducation program for 1.5 years postoperatively, were reevaluated with moving two-point discrimination and Semmes-Weinstein pressure threshold test after discontinuing sensory reeducation for 1 year. Another four patients with seven replanted or revascularized digits, who have never received sensory reeducation after surgery, were also followed up in the same way. After cessation of sensory reeducation, the degree of moving two-point discrimination became significantly worse in the formal sensory-reeducated group (P < 0.05) and significantly improved in the group without sensory reeducation initially (P < 0.05), whereas it showed a nonsignificant change of Semmes-Weinstein threshold both in the group with formal sensory reeducation and without sensory reeducation. Sensory retraining did influence the progressive change of moving two-point discrimination, but not in a parallel way with the Semmes-Weinstein threshold test.
对于再植手指而言,感觉再教育后感觉增益的长期维持情况仍不明确。对10例共18个接受再植或血管重建的手指且术后接受了1.5年正规感觉再教育计划的患者,在停止感觉再教育1年后,采用动态两点辨别觉和Semmes-Weinstein压力阈值测试进行重新评估。另外4例共7个接受再植或血管重建手指且术后从未接受感觉再教育的患者,也采用同样的方式进行随访。在停止感觉再教育后,正规感觉再教育组的动态两点辨别觉程度显著变差(P<0.05),而最初未接受感觉再教育组则显著改善(P<0.05),然而,正规感觉再教育组和未接受感觉再教育组的Semmes-Weinstein阈值均显示无显著变化。感觉再训练确实影响动态两点辨别觉的渐进性变化,但与Semmes-Weinstein阈值测试并非呈平行关系。