重症颅脑损伤患者早期功能锻炼规范化的应用效果研究

The application of standardized early function training in patients with severe brain injury

目的探索以多学科合作为基础早期功能锻炼规范化在重症颅脑损伤患者中的应用效果。方法选取2017年1~11月于温岭市第一人民医院接受治疗的84例重症颅脑损伤患者为研究对象,按照随机数表法分为对照组和观察组,对照组采用常规康复锻炼方法,观察组采用以多学科合作为基础早期功能锻炼规范化方法。收集两组患者住ICU时间、平均气管插管时间、住院天数、并发症发生情况以及预后不良发生率。结果观察组住ICU时间(25.36±5.17)h,平均气管插管时间(10.12±2.31)h,住院天数(9.05±1.45)d,短于对照组住ICU时间(49.23±8.07)h,平均气管插管时间(24.28±5.79)h,住院天数(15.26±2.83)d,差异有统计学意义(P<0.05)。观察组并发症总发生率为4.76%,低于对照组并发症总发生率16.66%,差异有统计学意义(P<0.05)。观察组预后不良发生率为2.38%,于对照组预后不良发生率19.05%相比,差异有统计学意义(P<0.05)。结论以多学科合作为基础的早期功能锻炼规范化能够有效降低重症颅脑损伤患者住ICU时间以及住院时间,且能够降低患者并发症发生率,提高患者预后质量。

Objective To assess the application of standardized multidisciplinary early function training in patients with severe brain injury.Methods 84 patients with severe traumatic brain injury treated in the First People′s Hospital of Wenling from January to November 2017 were recruited in our study and were evenly divided into the control group and the observation group using the random number table method.Subjects in the control group received routine rehabilitation training,while those in the observation group received standardized multidisciplinary early function training.Hours in ICU and hours with tracheal intubation,length of hospital stay,incidence of complication and occurrence of poor prognosis of patients in the two groups were compared.Results Compared to controls,patients in the observation group spent significantly less hours in ICU(25.36±5.17 vs 49.23±8.07)and less days in hospital(9.05±1.45 vs 15.26±2.83)and with less hours of tracheal intubation(10.12±2.31 vs 24.28±5.79),the differences were all statistically significant(P<0.05).The overall incidence rate of complications and occurrence rate of poor prognosis of patients in the observation group were both significantly lower than that of controls(4.76%vs 16.67%;2.38%vs 19.05%;P<0.05).Conclusions The standardized multidisciplinary early function training can effectively shorten the length of ICU stay and hospital stay of patients with severe traumatic brain injury and also can significantly reduce the incidence of complications and improve the prognosis quality of patients.