早期康复干预对脊髓和脑损伤患者前3个月功能恢复的影响

Effects of early rehabilitation intervention on functional rehabilitation of patients with spinal cord and brain injury in the early 3 months

目的:脊髓和脑复合性损伤患者救治成功后,常遗留不同程度的功能障碍,探讨早期康复干预对脊髓和脑损伤患者前3个月功能恢复的影响。方法:85例脊髓和脑损伤患者分为治疗组43例和对照组42例。对照组给予创伤常规治疗(必要的手术、脱水、抗生素、一般的神经营养药治疗及针灸治疗);治疗组除给予上述的常规治疗外,给予综合性康复治疗(运动疗法、功能性电刺激、高压氧、认知功能训练及心理治疗),两组患者均在治疗前和治疗后第3个月由专业康复医师进行格拉斯哥昏迷量表(Glascowcomascale,GCS)、神经功能缺损程度(Neuralfunctiondefi-ciency,NFD)评定、Fugl-Meyer评定(Fugl-Meyerassessment,FMA)及Barthel指数(Barthelindex,BI)评定。结果:经治疗3个月后,治疗组GCS,FMA,BI由5.9±1.1,16.37±16.90,16.48±7.21升至14.1±1.0,68.51±17.52,71.39±25.90,神经功能缺损由17.06±9.21降至9.56±7.43;对照组相应为10.2±1.8,47.29±20.54,54.03±18.09和13.22±7.89,与治疗组比较t=3.031,3.067,3.405,3.351,P均<0.01。结论:早期康复干预能更有效地提高脑和脊髓损伤患者的意识清醒度,促进神经功能及肢体运动功能恢复,提高患者生活质量。

AIM:The patients with spinal and brain injury often leave over dysfunction in different degrees after successful treatment, and the aim of the paper is to explore the effects of early rehabilitation intervention on the functional rehabilitation of patients with combined spinal cord and brain injury in the early 3 months. METHODS:Eighty five patients with combined injury of spinal cord and brain were divided into treatment group(43 cases) and control group(42 cases).The control group was given wound routine treatment(necessary operation, dehydration, antibiotics,common nerve dietetic drug and acupuncture treatment);The treatment group was given comprehensive rehabilitation therapy(cinesiateics, functional electrical stimulation,hyperbaric oxygen,training of cognitive function and psychological treatment) besides the routine treatment mentioned above. The patients in the two groups were all evaluated with Glascow coma scale(GCS), neural function deficiency(NFD),Fugl Meyer assessment(FMA) and Barthel index(BI) by professional rehabilitation physician before and 3 months after treatment. RESULTS:After 3 month treatment,the scores of GCS,FMA and BI in the treatment group increased from 5.9±1.1, 16.37±16.90 and 16.48±7.21 to 14.1±1.0, 68.51±17.52 and 71.39±25.90 respectively.NFD score descended from 17.06±9.21 to 9.56±7.43;The corresponding data in the control group were 10.2±1.8, 47.29±20.54, 54.03±18.09 and 13.22±7.89 and there were significant differences between the two groups(t=3.031,3.067,3.405, 3.351,P< 0.01). CONCLUSION:Early rehabilitation intervention can efficiently improve the conscious level of patients with spinal cord and brain injury, and promote the rehabilitation of neural function and motor function of limbs and the quality of life.