重度脑外伤患者长期功能结局的影响因素  

Influence Factors Related to Long-term Outcome for Patients with Severe Traumatic Brain Injury

作　　者：张欣[1,2] 张小年[1,2] 孙新亭[1,2] 迟茜茜[1,2] ZHANG Xin;ZHANG Xiao-nian;SUN Xin-ting;CHI Qian-qian(the Third Department of Neural Rehabilitation,Beijing Bo'ai Hospital,China Rehabilitation Research Center,Beijing 100068,China;Capital Medical University School of Rehabilitation Medicine,Beijing 100068,China)

机构地区：[1]中国康复研究中心北京博爱医院神经康复三科,北京市100068 [2]首都医科大学康复医学院,北京市100068

出　　处：《中国康复理论与实践》2020年第9期1089-1092,共4页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的了解重度脑外伤患者1年随访结局及其相关因素。方法2015年1月至2018年12月,重度脑外伤患者135例,住院期间记录性别、发病年龄、教育年限、损伤部位、病变侧,并采用残疾等级量表(DRS)、简易精神状态检查(MMSE)、Fugl-Meyer评定量表(FMA)运动和平衡部分,以及改良Barthel指数(MBI)进行评定。出院后随访1年,再次评定DRS。结果发病年龄(r=0.188)、初次DRS评分(r=0.530)、MMSE评分(r=-0.376)、FMA运动部分评分(r=-0.284)、FMA平衡部分评分(r=-0.425)、MBI评分(r=-0.480)、脑干受损(r=0.194)、弥漫性脑损伤(r=0.202)与随访时DRS评分相关(P<0.05);性别(r=-0.175)、初次DRS评分(r=0.586)、MMSE评分(r=-0.242)、FMA运动部分评分(r=-0.301)、FMA平衡部分评分(r=-0.228)、MBI评分(r=-0.367)、枕叶受损(r=0.209)与DRS差值相关(P<0.05)。结论重度脑外伤患者的受伤年龄、早期认知和运动功能障碍程度,影响患者长期结局,仍需进一步研究损伤部位对长期结局的影响。Objectives To investigate the factors related to the long-term outcome for patients after severe traumatic brain injury.Methods From January,2015 to December,2018,135 patients with severe traumatic brain injury were selected.Their gender,age(of onset),education level,injury sites,and lesion side were recorded,and they were assessed with Disability Rating Scale(DRS),Mini-Mental State Examination(MMSE),Fugl-Meyer Assessment(FMA)for motor and balance and modified Barthel Index(MBI).They were assessed with DRS again one year after discharge.Results The age(r=0.188),early DRS score(r=0.530),MMSE score(r=-0.376),FMA for motor(r=-0.284)and balance(r=-0.425)score,MBI score(r=-0.480),brain stem injury(r=0.194)and diffuse brain injury(r=0.202)were related to DRS scores as follow-up(P<0.05);while,the gender(r=-0.175),early DRS score(r=0.586),MMSE score(r=-0.242),FMA for motor(r=-0.301)and balance(r=-0.228)score,MBI score(r=-0.367)and occipital lobe injury(r=0.209)were related to difference of DRS(P<0.05).Conclusion The age,early cognitive and motor dysfunction are related with the outcome of one year of patients after severe traumatic brain injury.More researches are needed to explore the impact of injury sites on the outcome.

关 键 词：脑外伤 残疾等级量表 相关因素 结局 

分 类 号：R651.1[医药卫生—外科学]