颅脑外伤患者高压氧介入时间对FIM评分的影响

目的：观察颅脑外伤患者高压氧介入时间对功能独立性评定（FIM）评分的影响，为探讨综合康复治疗最佳介入时机提供临床依据。方法选择中重型颅脑外伤患者130例，根据受伤时间分为对照组25例，综合康复1组（TBI〈15d）与综合康复2组（15d≤TBI≤30d）各40例，综合康复3组（TBI〉30d）25例，均给予药物治疗和康复措施，综合康复各组在前述的基础上行高压氧治疗共40次，以治疗前和治疗第30天、60天的FIM评分进行疗效评价。结果资料完整、实际纳入组TBI患者共123例，各组临床资料有可比性。各组内TBI患者在治疗第30天、60天的FIM评分差异有统计学意义（P〈0.05）。各组间TBI患者第1天FIM评分差异无统计学意义（P〈0.05），对照组与综合康复1、2组在第30天、60天差异有统计学意义（P〈0.05）。结论三组TBI患者2个月内FIM评分改善呈匀速好转趋势，30d内的高压氧综合康复1、2组对认知与运动功能改善作用明显优于对照组，优于综合康复3组患者。

Objective To investigate the effect of Hyperbaric Oxygen Intervention in time on improving the FIM scores in Traumatic Brain Injury patients and provide clinical evidence on discussing the best Intervene opportunity of comprehensive rehabilitation therapy. Method Choosing 130 patients with middle or sever cerebral injury and dividing into several groups according to the time of injury ：25 cases of control group,40 cases both in the second group of comprehensive rehabilitation（TBI〈15 days）and the third group of comprehensive rehabilitation（15 days〈TBI〈30 days）,25 cases of the forth group of comprehensive rehabilitation（TBI〉30 days）,all give drug therapies and rehabilitation measures. Additional 40 times hyperbaric oxygen therapy is added to the comprehensive rehabilitation group and FIM scores are used to evaluate curative effect. Outcome TBI patients with integral data in included groups are 123 cases.Each baseline is consistent with comparability. The FIM score is different in each group of patients with TBI during treatment in the 30th,60th day（P〈0.05）. The FIM score in the first day of patients with TBI is with no difference（P〉0.05）. FMI score in control group and comprehensive rehabilitation 1,2 groups is different in the 30th,60th day（P〈0.05）. Conclusion FIM score improving is moving a rising trend during two months. FIM score improving in hyperbaric oxygen comprehensive 1,2 groups are significantly better than in the control group. Both the two groups are ahead of TBI〉30 days group in which patients are starting to receive hyperbaric oxygen therapy.