脑外伤后患者的生活质量

Review on the Quality of live in Patient with Traumatic Brain Injury

目的:探讨脑外伤后患者稳定期的生活质量及其高与低的患者在人口统计学,社会功能,认知功能之间的差异。方法:脑外伤后稳定期患者46名中筛选生活质量高与低的患者各15名后在患者亲属中根据年龄、性别、受教育程度设为对照组,通过QOLI、SIP、PIL、HISC、NRS量表进行生活质量,社会功能,生活目的,主观及客观神经行为评价。结果:1)脑外伤患者的生活质量为正常人的三分之一(66.1±23.4:6.5±2.5),社会功能及生活目的比对照组较低,主观及客观神经行为症状有显著性差异(P<0.01)。2)生活质量高的患者在外伤前后的智能上显著高于生活质量低的患者(P<0.05;P<0.01)。3)生活质量高的患者在社会功能,生活目的上显著高于生活质量低的患者并且主观及客观症状少于生活质量低的患者(P<0.01;P<0.05)。4)重度脑外伤患者比中度脑外伤患者在社会功能障碍与主观症状尤为突出(P<0.05;P<0.05),但在生活质量,生活目的,客观症状差异无显著性。结论:脑外伤后患者的生活质量在稳定期也明显低于比正常人,生活质量高的患者比生活质量低的患者在外伤前后的智能要高,外伤程度低,社会功能和生活目的高,主观及客观症状更少。

Objective：This study was designed to investigate the Quality of Life （QOL）level of the patient with TBI after the symptoms of the sequelae stabilized, and the differences between the patients with higher QOL and those with lower QOL in demographic variables, Psychosocial functioning, and neurobehavioral symptoms. Methods ： The subjects were composed of patients with higher QOL（ N = 15, Group 1 ） and those with lower QOL（ N = 15, Group 2） , who were assigned according to level of QOL among 46 patients with TBI, and 30 normal control group. The levels of QOL, psychosocial functioning, purpose in life, and subjective and objective neurobehavioral symptom were rated by QOLI, SiP, PIL, HISC and NRS. Results ： 1 ） In comparing the normal control group, QOL lev- el of TBI group remained about 1/3 of that of control（66.1 ± 23.4：6.5 ±2.5 ,respectively）. The brain injured patients had significantly lower levels of psychosocial functioning and purpose in life （ P 〈 0.01 ） , and more severe subjective and objective neurobehavioral symptoms（ P 〈 0. 01 ）. 2）In comparing demographic and clinical variables between Group 1 and Group 2, pre - and post - injury IQ of Group 1 were significantly higher than those of Group 2 （P 〈 0.05;P 〈 0.01, respectively）. But significant differences were not found in other variables. 3） Group 1 had significantly higher psychosocial function and purpose in life levels, and less subjective and objective symptoms than Group 2 （ P 〈 0.01 ; P 〈 0.05 ; P 〈 0.01 ; P 〈 0.05, respectively）. 4） STBI experienced more severe psycho- social impairment and subjective symptoms than MTBI （P 〈 0.05 ;P 〈 0. 05 ）. However, in QOL and purpose in life level and objective symptoms there were no difference between STBI and MTBI. Conclusions ： The Quality of live in patient with TBI were also significantly lower than normal people and Quality of life in patients with high ratio of low quality of life in patients with trauma and intelligence to high, low degree of trauma, social function and life aim high, subjective and objective symptoms less.