《国际功能、残疾和健康分类康复组合》对创伤性脊髓损伤恢复期患者康复疗效和成本效益的初步报告  

Preliminary report on the therapeutic effect and cost-effectiveness of ICF-RS in the traumatic spinal cord injured patients during convalescent stage

作　　者：何晓阔 余果[1,2] 陈铖 张少武 陈智康[3] 陈善佳 HE Xiaokuo;YU Guo;CHEN Cheng(The Fifth Hospital of Xiamen,Xiamen,361000)

机构地区：[1]厦门市第五医院康复医学科,厦门361000 [2]厦门市脑病康复技术转化重点实验室 [3]湖北医药学院附属太和医院

出　　处：《中国康复医学杂志》2021年第3期299-304,共6页Chinese Journal of Rehabilitation Medicine

摘　　要：目的:采用ICF康复组合(ICF-RS)评价脊髓损伤患者的功能状况,初步分析康复疗效与成本效益关系。方法:15例创伤性脊柱脊髓损伤(TSCI)恢复期患者进行为期2周的集中康复训练,通过ICF-RS评估患者的功能改善情况,记录康复医疗支出。结果:TSCI恢复期患者最常见的身体功能障碍主要为b730肌肉力量、b640性功能、b455运动和耐受能力、b280痛觉、b710关节活动能力;活动和参与功能障碍主要为d770亲密关系、d455到处移动、d450步行、d415保持一种身体姿势、d410改变身体基本姿势、d470利用交通工具、d850有报酬的就业、d570照顾个人健康、d920娱乐与休闲。康复治疗后患者总体功能改善平均9.6分,30条类目中13条明显改善(P<0.05),包括睡眠、情绪、痛觉、排尿,以及改变身体基本姿势、移动自身、步行、盥洗自身、穿着、照顾个人健康、做家务、基本的人际交往、娱乐与休闲。每人总医疗支出平均(8126.70±2631.69)元,康复总支出为(6610.83±2692.62)元,总体功能每改善1分,平均需要支出846.55元,其中康复支出688.63元。结论:ICF-RS可以用于评估脊髓损伤患者的功能状况,指导患者的康复治疗和疗效评价。Objective:To apply ICF rehabilitation set(ICF-RS)to assess functional status of the convalescent patients with traumatic spinal cord injury(TSCI).To preliminary analyze the relationship between therapeutic effect and cost-benefit of rehabilitation medicine.Method:Fifteen convalescent TSCI patients were enrolled into a 2-week intensive rehabilitation program.Functional improvement was assessed by ICF-RS and rehabilitation medical expenses were recorded in hospitalizations.Result:The Body Function impairments in TSCI patients were mainly concentrated in b730 Muscle power functions,b640 Sexual functions,b455 Exercise tolerance functions,b280 Sensation of pain,b710 Mobility of joint functions,main obstacles in domain of Activity and Participation were d770 Intimate relationships,d455 Moving around,d450 Walking,d415 Maintaining a body position,d410 Changing basic body position,d470 Using transportation,d850 Remunerative employment,d570 Looking after one's health,d920 Recreation and leisure.After intensive rehabilitation program,the overall functional improvement averaged 9.6 points,in which 13 of the 30 ICF categories were significantly improved(P<0.05),including Sleep functions,Emotional functions,Sensation of pain,Urination functions,Changing basic body position,Transferring oneself,walking,Washing oneself,Dressing,Looking after one's health,Doing housework,Basic interpersonal interactions,Recreation and leisure.The total medical expenditure per person averaged(8126.70±2631.69)Yuan,and the total rehabilitation cost per person averaged(6610.83±2692.62)Yuan.If rising every 1 point score of total function,the average medical expense per person was 846.55 Yuan,including 688.63 Yuan for rehabilitation medicine.Conclusion:ICF-RS can be used to assess the functional status of TSCI patients as well as the management of rehabilitation program and efficacy evaluation.

关 键 词：脊髓损伤 康复 国际功能、残疾和健康分类 成本效益分析 

分 类 号：R744[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]