重度创伤性颅脑损伤恢复期病人高压氧联合康复训练的效果分析

COMBINED EFFECT OF HYPERBARIC OXYGEN AND REHABILITATION TRAINING ON CONVALESCENT PATIENTS WITH SEVERE TRAUMATIC BRAIN INJURY

目的:探讨重度颅脑损伤恢复期病人高压氧联合康复训练的效果。方法:将82例重度颅脑损伤恢复期病人随机分为对照组和治疗组,均给予高压氧等常规治疗,仅治疗组加用康复训练;分析治疗前、治疗2mo后两组的抑郁状态、意识状态、认知功能情况、日常生活活动能力、上下肢运动功能和平衡功能及握力和手指屈肌张力情况。结果:两组治疗后的以上评分均优于治疗前,具有统计学差异(P<0.05或P<0.01);治疗组治疗后的HAMD评分低于对照组(P<0.05)、GCS评分(P<0.05)、NCSE评分(P<0.01)、Barthel指数(P<0.01)、握力(P<0.05)、上下肢运动功能评分(P<0.01)和平衡功能评分均高于对照组(P<0.05)。结论:高压氧联合康复训练治疗重度颅脑损伤恢复期病人的效果较好,不仅可改善运动功能,而且还可以改善抑郁、认知及意识状态,可在该类病人康复治疗中进行推广。

Objective: To explore the combined effect of hyperbaric oxygen and rehabilitation training on convalescent patients with severe traumatic brain injury. Methods: 82 convalescent patients with severe traumatic brain injury admitted by our hospital from February 2011 to June 2012 were randomly divided into the Therapeutic group and the control group. Both groups were given conventional treatments including hyperbaric oxygen,while only the Therapeutic group received rehabilitation training additionally. The state of depression( HAMD score),consciousness( Glasgow Coma Scale GCS score),cognitive function( the Chinese version of the neurobehavioral cognitive status assessment,NCSE),activities of daily living( Barthel Index),upper and lower extremity motor function and balance function( simplified Fugl- Meyer motor function assessment scale,FMA) and grip strength and finger flexor tension( modified Ashworth grading) before and 2ndmonth after treatment were compared between groups. Results: The above ratings are better than before treatment,with a statistically significant difference( P <0. 05 or P <0. 01). Compared with the Control group,the therapeutic group got a lower HAMD score( P < 0. 05) and a higher GCS score( P < 0. 05),NCSE score( P < 0. 01),Barthel index( P < 0. 01),grip strength( P < 0. 05),upper and lower limbsmotor scores( P < 0. 01) and balance function scores( P < 0. 05). Conclusions: The combined effect of hyperbaric oxygen and rehabilitation training on convalescent patients with severe traumatic brain injury was better,worth promoted in the rehabilitation of these patients.