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系統識別號 U0026-0812200911394039
論文名稱(中文) 以解剖上嚴重程度預測職業性手外傷後之手功能
論文名稱(英文) Prediction of Hand Function after Occupational Hand Trauma by Evaluation of Initial Anatomical Severity
校院名稱 成功大學
系所名稱(中) 環境醫學研究所
系所名稱(英) Institute of Environmental and Occupational Health
學年度 93
學期 2
出版年 94
研究生(中文) 李佳玲
研究生(英文) Chia-Ling Lee
電子信箱 cathyleetw@gmail.com
學號 s7691115
學位類別 碩士
語文別 英文
論文頁數 59頁
口試委員 口試委員-黃茂雄
口試委員-邱浩遠
指導教授-郭育良
口試委員-郭浩然
中文關鍵字 Purdue Pegboard測驗  通用性向測驗  職業性手外傷  手功能   
英文關鍵字 occupational hand trauma  hand function  HISS  GATB  Purdue Pegboard test 
學科別分類
中文摘要   在台灣,手外傷是常見的職業傷害。過去的研究曾訂出了一個手外傷嚴重度評量系統(HISS),以表皮、骨骼、運動、及神經系統之總分數來預測個案復工的情形。然而這套系統的對於手外傷後手功能的預測力卻沒有直接的驗證。因此,本研究的目的在探討手外傷嚴重度評量系統的得分與職業性手外傷後手功能的相關性。

  選取南台灣某醫學中心自2000年1月至2003年12月因職業性手外傷住院開刀逾一年以上的個案,以病歷取得受傷時的嚴重度,並接受手功能測試(包括通用性向測驗及Purdue Pegboard測驗)。最後完成測試的個案有96位。結果發現,在校正前後手外傷嚴重度評量系統的總得分和通用性向測驗中的手指靈巧及傷手靈巧有顯著的負相關,與Purdue Pegboard測驗中雙手、組合及傷手的成績也都有顯著的負相關,然而表皮、骨骼、運動、及神經四個系統中並非每一系統都與手功能測驗有顯著相關。

  因此本研究認為以手外傷嚴重度評量系統評估的解剖嚴重度對於職業性手外傷後的手功能的確有預測力,但似乎需再做些修正以達到更好的預測能力。

英文摘要   Hand trauma is a common occupational injury in Taiwan. The Hand Injury Severity Scoring (HISS) system was developed to predict time to return-to-work after hand trauma using a composite score combining integument, skeletal, motor, and neural components. However, direct examination of the predictability of this system for hand function after hand trauma was lacking. The purpose of this study was to examine the relationship between initial HISS and recovered hand function after occupational hand trauma.

  Patients hospitalized between January 1, 2000 and December 31, 2003 in one tertiary referral center in South Taiwan for surgery due to occupational hand trauma were recruited. The severity of hand trauma was evaluated by chart review. Hand function tests, including General Aptitude Test Battery (GATB) and the Purdue Pegboard test, were performed. Ninety six patients completed the study. We found significant negative correlation between total HISS score and finger dexterity and injured hand dexterity in GATB before and after adjustment. There were also similar correlations between total HISS score and scores for both hands, assembly and injured hand in the Purdue Pegboard test. However, not all individual components of these four were significantly associated with the hand functions.

  The study showed that after occupational hand trauma, initial anatomic severity evaluated by the HISS system could predict hand function post-surgically. However, further adjustment is warranted to improve the predictability.

論文目次 ABSTRACT IN CHINESE ..........................................................1
ABSTRACT IN ENGLISH ..........................................................2
ACKNOWLEDGE ..................................................................3
INDEX OF APPENDIX ............................................................6
INDEX OF TABLE ...............................................................7
INDEX OF FIGURE ..............................................................8

CHAPTER ONE PREFACE .........................................................9
Section One Background ......................................................9
Section Two Purpose .........................................................9
Section Three Significance ..................................................9

CHAPTER TWO LITERATURE REVIEW ..............................................11
Section One International Classification of Functioning, Disability and Health (ICF) ................................................................11
Section Two Hand Injury Severity Scoring (HISS) system .....................11
Section Three Domains of previous studies...................................12

CHAPTER THREE MATERIALS AND METHODS ........................................14
Section One Subject ........................................................14
Section Two Hand Injury Severity Scoring (HISS) System .....................14
Section Three General Aptitude Test Battery (GATB) .........................15
Section Four Purdue Pegboard test...........................................16
Section Five Statistics ....................................................17

CHAPTER FOUR RESULTS .......................................................18
Section One Demographic data ...............................................18
Section Two Hand Injury Severity Scoring ...................................18
Section Three GATB and Purdue Pegboard test .................................18
Section Four Correlation between HISS and GATB / Purdue

Pegboard test.......19
CHAPTER FIVE DISCUSSIONS ...................................................21

CHAPTER SIX CONCLUSION .....................................................23

REFERENCE ...................................................................24
APPENDIX ....................................................................25
TABLES ......................................................................27
FIGURES .....................................................................43
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Campbell DA and Kay SPJ. The hand injury severity scoring system. Journal of Hand Surgery (British and European Volume), 21B:3: 295-298, 1996.

Fayad F, Nuwayhid I, Tamim H, Kassak K and Khogali M. Cost of work-related injuries in insured workplaces in Lebanon. Bulletin of the World Health Organization, 81:509-516, 2003.

Institute of Occupational Safety and Health. Database of IOSH. Institute of Occupational Safety and Health, Taiwan.

Instructions and normative data for MODEL 32020 PURDUE PEGBOARD. Lafayette instrument company

Liu YH, Lin MR and Wang JD. Cost and determinants of morbidity from work related disabling injuries in Taiwan. Occupational and Environmental Medicine, 52:138-142, 1995.

Mink van der Molen AB, Matloub HS, Dzwierzynski W and Sanger JR. The hand injury severity scoring system and workers’ compensation cases in Wisconsin, USA. Journal of Hand Surgery (British and Europe an Volume), 24B:2: 184-186, 1999.

Mink van der Molen AB, Ettema AM and Hovius SER. Outcome of hand trauma: the hand injury severity scoring system (HISS) and subsequent impairment and disability. Journal of Hand Surgery (British and European Volume), 28B:4: 295-299, 2003.

O’sullivan ME and Colville J. The economic impact of hand injuries. Journal of Hand Surgery (British and European Volume), 18B:395-398, 1993.

Saxena P, Cutler L and Feldber L. Assessment of the severity of hand injuries using ‘hand injury severity score’, and its correlation with the functional outcome. Injury, Int. J. Care Injured, 35, 511-516, 2004.

World Health Organization. International Classification of Functioning, Disability and Health. World Health Organization, Geneva, 2002.
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