重型闭合性颅脑损伤综合康复的效果评定

The Assessment of Rehabilitation Treatment for Severe Traumatic Brain Injury

目的 :研究康复科住院的重型闭合性颅脑损伤患者经综合康复治疗后残疾水平恢复情况及影响残疾水平恢复的因素。方法 :对 4 9例住院的重症闭合性颅脑损伤患者进行回顾性调查研究。在入院后及出院前采用残疾分级量表 (DRS)对患者的残疾水平进行评定 ;患者的年龄、性别、病程、康复治疗时间对康复治疗效果的影响进行多元回归分析 ,并分析昏迷时间与DRS评分的关系。结果 :治疗前与治疗后DRS评定结果差异有显著性 ,残疾水平明显下降。非手术组改善较手术组明显 ,考虑与手术组病情较重有关。DRS评定结果与昏迷时间及治疗时间有关 ,康复治疗时间长则功能恢复好 ,残疾水平低。结论 :综合康复治疗后残疾水平明显降低 ;昏迷时间短及康复治疗时间长则残疾水平低 ;

Objective: To study the therapeutic effect of comprehensive rehabilitation therapy and influencing factors of severe closed traumatic brain injury patients. Methods: A retrospective study was performed on 49 patients with severe closed traumatic brain injury. The disability was assessed by using disability rating scale (DRS) before and after the rehabilitation treatment. The effect of age, sex, course and treating duration on the therapeutic effect of comprehensive rehabilitation therapy was analyzed by multiple linear regression and the relationship between coma time and DRS was assessed. Results: There were evidently different after treatment in DRS assessment. The disability level was decreased. The difference of DRS had a negative relationship with coma time ( P < 0.01 ) and positive relationship with treatment time ( P < 0.05 ). The longer treatment time was, the lower disability level was. Conclusion: The integrative rehabilitation treatment can decrease the level of disability in severe traumatic brain injury. The shorter coma time and longer treatment time is, the lower disability level is. The degree of traumatic brain injury was the most important factor for the outcome.