重型颅脑损伤患者术后肢体运动功能恢复的相关影响因素及康复措施  

The related influencing factors and rehabilitation measures of postoperative limb motor function recovery in patients with severe craniocerebral injury

作　　者：张永丽 ZHANG Yongli(Department of Rehabilitation,the 990th Hospital of PLA Joint Logistic Support Force,Zhumadian,Henan 463000,China)

机构地区：[1]联勤保障部队第九九〇医院康复科,河南驻马店463000

出　　处：《现代医药卫生》2024年第7期1162-1166,共5页Journal of Modern Medicine & Health

摘　　要：目的分析重型颅脑损伤(SCI)患者术后肢体运动功能恢复的相关影响因素及康复措施。方法回顾性选取2021年3月至2023年3月该院神经外科收治的86例SCI患者的临床资料。所有患者均接受标准去骨瓣减压术治疗及术后肢体运动功能康复训练。经单因素、logistic回归分析找出影响SCI患者术后肢体运动功能恢复的危险因素,并分析康复训练对患者肢体功能改善的应用价值。结果经单因素分析,两组年龄、格拉斯哥昏迷(GCS)评分、运动功能区损伤、脑疝、康复治疗介入时间、意识障碍时间比较,差异均有统计学意义(P<0.05);经logistic回归分析得出,年龄≥50岁、GCS评分3~5分、运动功能区损伤、脑疝、意识障碍时间>10 d均为SCI患者术后发生肢体运动功能障碍的危险因素(P<0.05),康复治疗介入时间≤30 d为SCI患者术后发生肢体运动功能障碍的保护因素(P<0.05)。干预后,8例患者肢体运动功能恢复正常,明显肢体运动功能障碍患者较干预前降低,差异有统计学意义(P<0.05),干预前后,轻度、中度、重度肢体功能障碍患者比较,差异均无统计学意义(P>0.05)。结论年龄≥50岁、GCS评分3~5分、运动功能区损伤、脑疝、意识障碍时间>10 d均为SCI患者术后发生肢体运动功能障碍的危险因素,术后应尽早采取康复措施,有利于术后肢体运动功能恢复。Objective To analyze the related influencing factors and rehabilitation measures of postoperative limb motor function recovery in patients with severe craniocerebral injury(SCI).Methods The clinical data of 86 patients with SCI admitted to the Department of Neurosurgery of the hospital from March 2021 to March 2023 were retrospectively selected.All patients received standard decompressive craniectomy and postoperative limb motor function rehabilitation training.Univariate and logistic regression analysis were used to find out the risk factors affecting the recovery of limb motor function in patients with SCI,and to analyze the value of rehabilitation training in the improving limb function.Results Univariate analysis showed that there were statistically significant differences in age,Glasgow coma score(GCS score),motor function area injury,cerebral hernia,rehabilitation intervention time and disturbance of consciousness time between the two groups(P<0.05).Logistic regression analysis showed that age≥50 years old,GCS score 3-5 points,motor function area injury,cerebral hernia,and disturbance of consciousness time>10 days were all risk factors for limb motor dysfunction after SCI(P<0.05).Rehabilitation intervention time≤30 days was a protective factor for limb motor dysfunction after SCI(P<0.05).After intervention,the limb motor function of eight patients returned to normal,and the patients with obvious limb motor dysfunction were lower than those before intervention,and the difference was statistically significant(P<0.05).Before and after intervention,there was no significant difference in patients with mild,moderate and severe limb dysfunction(P>0.05).Conclusion Age≥50 years old,GCS score of 3-5 points,motor function area injury,cerebral hernia,and disturbance of consciousness time>10 days are all risk factors for limb motor dysfunction in SCI patients after surgery.Postoperative rehabilitation measures should be taken as soon as possible,which is conducive to the recovery of limb motor function after surge

关 键 词：重型颅脑损伤 肢体运动功能 危险因素 康复措施 

分 类 号：R651.15[医药卫生—外科学]