颅脑外伤患者综合康复治疗的时效性研究  

The Study on clinical effect of treating TBI with comprehensive rehabilitation

作　　者：李爱萍[1] 余芳[1] 周先珊[1] 吴立红[1] 董晓敏[1] 谢漫 

机构地区：[1]南京军区杭州疗养院全军创伤康复中心,浙江杭州310007

出　　处：《东南国防医药》2014年第2期132-134,共3页Military Medical Journal of Southeast China

基　　金：南京军区医药创新重点资助项目(09Z037)

摘　　要：目的研究不同时机、不同频度介入综合康复训练对颅脑外伤(traumatic brain injury,TBI)患者康复疗效的影响。方法选择中、重度颅脑损伤308例,随机分为康复1组94例(TBI病程<15 d)和康复2组87例(TBI病程≥15 d),康复3组62例(康复训练1次/d),康复4组65例(康复训练2次/d)。于治疗前、后分别采用运动功能评定量表(fugl-meyer,FMA)、功能独立性测评量表(functional independence measure,FIM)、改良巴氏指数(modified barthel index,MBI)、简明精神量表(mini-mental state examination,MMSE)对TBI患者进行认知及运动功能评估。结果四组康复治疗后1、2、3个月的MMSE、FIM、FMA的各项评分均有显著提高(P<0.01),且改善程度康复1组优于康复2组(P<0.05或0.01);康复4组优于康复3组(P<0.05或0.01)。结论早期系统正规的康复治疗有利于TBI患者认知功能、运动功能和日常生活活动能力的改善,且早期介入适量频度的康复治疗更能促进功能的全面恢复。Objective To discuss the effect of early rehabilitation with different timing and frequency on patients with trau -matic brain injury （TBI）.Methods 308 patients with medium and severe TBI were selected ,and divided randomly into four teams with 94 in rehabilitation team 1 （ early rehabilitation started within 15 days after injury ） ,87 in rehabilitation team 2 （ early rehabilitation started 15 days after injury）,62 in rehabilitation team 3 （1/d） and 65 in rehabilitation team 4 （2/d）.Before and after the treatment, we made evaluations on the cognitive and motor function of patients with TBI with Fugl -Meyer ,Functional independence measure ,Modi-fied Barthel index and Mini-mental state examination .Results Comparing the status of TBI patients in four teams after one month /two months/three months with that of the same patients before treatment ,all key indicators improved significantly （P〈0.01） with team 1 improved more significantly than team 2 （P〈0.05 or 0.01） and team 4 more significantly than team 3 （P〈0.05 or 0.01）.Conclu-sion Systematic comprehensive rehabilitation at early stage of TBI is beneficial for the improvement of living quality and cognitive function of TBI patients and the appropriate application of early comprehensive rehabilitation can make the improvement even better .

关 键 词：颅脑外伤 综合康复 临床疗效 

分 类 号：R651.15[医药卫生—外科学]