基于ICF理念的康复治疗方案在上颈段脊髓损伤患者中的应用效果  

Application effect of ICF concept-based rehabilitation treatment regimen in patients with upper cervical spinal cord injury

作　　者：谭治标 李敏[3] 许建文[3] 桂裕昌 胡金翠 黄潇潇 肖慧萍 谢莹[3] 吴京谕 TAN Zhi-biao;LI Min;XU Jian-wen;GUI Yu-chang;HU Jin-cui;HUANG Xiao-xiao;XIAO Hui-ping;XIE Ying;WU Jing-yu(The First Clinical Medical College,Guangxi Medical University,Nanning 530021,China;Department of Rehabilitation Medicine,Guigang People′s Hospital,Guigang 537100,China;Department of Rehabilitation Medicine,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一临床医学院,南宁市530021 [2]广西贵港市人民医院康复医学科,贵港市537100 [3]广西医科大学第一附属医院康复医学科,南宁市530021

出　　处：《广西医学》2022年第8期815-819,共5页Guangxi Medical Journal

基　　金：广西科技计划(桂科AB20159027);广西医疗卫生适宜技术开发与推广应用项目(S2018021);广西壮族自治区临床重点专科建设项目[桂卫医发〔2018〕6号]。

摘　　要：目的探讨基于国际功能、残疾和健康分类(ICF)理念的康复治疗方案在上颈段脊髓损伤患者中的应用效果。方法将52例上颈段(C_(1)~C_(4))脊髓损伤患者随机分为对照组(26例)和观察组(26例)。对照组患者采用传统康复方案进行治疗,观察组患者采用基于ICF理念的康复方案进行治疗。分别于治疗前及治疗后4周、8周,采用改良Barthel指数评价患者的日常生活活动能力(ADL),采用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评价两组患者的生活质量,并比较两组患者治疗后4周、8周的并发症发生率。结果(1)治疗后4周、8周,两组患者的ADL评分均较治疗前提高,且观察组的ADL评分高于对照组(均P<0.05)。(2)治疗后4周观察组WHOQOL-BREF中的心理维度评分,以及治疗后8周观察组WHOQOL-BREF中的心理评分、社会维度评分和环境维度评分均高于治疗前及对照组(均P<0.05)。(3)治疗后4周、8周,两组的并发症发生率差异均无统计学意义(均P>0.05)。结论基于ICF理念的康复治疗可更有效地改善上颈段脊髓损伤患者的ADL、心理状况及社会适应能力,有利于调适患者独立生活的居住环境,进而提高患者的生存质量。Objective To explore the application effect of rehabilitation treatment regimen based on the concept of International Classification of Functioning,Disability and Health(ICF)in patients with upper cervical spinal cord injury.Methods Fifty-two patients with upper cervical(C_(1)-C_(4))spinal cord injury were randomly divided into control group(26 cases)and observation group(26 cases).Patients in the control group were treated with traditional rehabilitation regimen,while patients in the observation group were treated with ICF concept-based rehabilitation regimen.Before the treatment and four and eight weeks after the treatment,modified Barthel index was used to assess the ability of activities of daily living(ADL)of the patients,and the World Health Organization Quality of Life Scale-Brief Version(WHOQOL-BREF)to evaluate the quality of life of the patients in both groups.Besides,the incidence rates of complications four and eight weeks after the treatment were compared between the two groups.Results(1)Four and eight weeks after the treatment,ADL scores in both groups were elevated as compared with those before the treatment,and the observation group exhibited higher ADL scores than the control group(all P<0.05).(2)The observation group yielded a higher score for psychological dimension in the WHOQOL-BREF four weeks after the treatment,as well as higher scores for psychological,social,and environmental dimensions in the WHOQOL-BREF eight weeks after the treatment in comparison with the pretreatment scores or those of the control group(all P<0.05).(3)Four and eight weeks after the treatment,there was no statistically significant difference in the incidence rates of complications between the two groups(all P>0.05).Conclusion For patients with upper cervical spinal cord injury,ICF concept-based rehabilitation therapy can improve their ADL,mental condition,and social adaptability more effectively and is conductive to the improvement of the dwelling environment in which patients live independently,thus increasing patient

关 键 词：上颈段脊髓损伤 国际功能、残疾和健康分类理念 康复治疗 日常生活活动能力 生存质量 

分 类 号：R493[医药卫生—康复医学] R653[医药卫生—临床医学]