重型颅脑损伤患者的早期康复治疗

Effect of Early Rehabilitation on Patients with Severe Traumatic Brain Injury

目的探讨重型颅脑损伤患者的早期康复效果。方法89例重型颅脑损伤患者随机分为治疗组49例和对照组40例。两组患者均给予神经外科常规护理及脱水剂、脑保护剂、营养支持,防治并发症等治疗;治疗组在此基础上增加康复治疗,以物理治疗为主,结合作业治疗、心理治疗、语言治疗。比较两组患者治疗前后的日常生活活动能力(ADL)测评、残疾分级量表(DRS)测评、Fugl-Meyer运动功能积分和认知功能评定简易精神状态检查表评分(MMSE),以及平衡功能等。结果治疗组和对照组患者治疗前后的ADL、DRS、Fugl-Meyer积分和平衡功能差异有显著性意义(P<0.05),MMSE评分差异无显著性意义(P>0.05)。结论早期康复治疗能够最大限度地恢复重型颅脑损伤患者的功能,明显提高其生活质量和生活自理能力。

Objective To explore the effect of early rehabilitation on patients with severe traumatic brain injury. Methods 89 patients with severe traumatic brain injury were divided randomly into the treatment group （49 cases） and control group （40 cases）. All patients of two groups were treated with routine nursing, dehydrated drug, brain protective therapy and alimental therapy, and measures of preventing complications. While, the patients of the treatment group were added with motor and cognitive rehabilita- tion, mainly physical therapy, combined with occupational therapy, psychotherapy and speech therapy. All patients of two groups were evaluated with scores of activities of daily living （ADL）, Disability Rating Scale （DRS）, Fugl-Mayer Assessment （FMA）, Mini-mental status examination （MMSE）, three class balance scale before and after treatment. Results The scores of ADL, DRS, FMA and balance function of the patients in the treatment group were significantly different from that of the control group after treatment （ P 〈0.05）. The MMSE scores of two groups had no significantly difference after treatment （ P 〈0.05）. Conclusion Early rehabilitation can improve the brain function of the patients with severe traumatic brain injury, patients＇ living quality and ADL.