重型颅脑损伤患者伤后3个月肢体运动功能及肌力的影响因素分析

Influencing factors of limb motor function and muscle strength in patients with severe craniocerebral injury 3 months after injury

目的探讨重型颅脑损伤患者伤后3个月肢体运动功能及肌力的影响因素,以期为临床治疗提供参考。方法本研究选取2021年3—12月河南省焦作市人民医院收治的93例重型颅脑损伤患者为研究对象。收集患者一般资料。采用Fugl-Meyer量表(FMA)评估患者意识清醒时、受伤后3个月的肢体运动功能;采用Lovett肌力分级评估患者意识清醒时、受伤后3个月的肌力。采用多因素Logistic回归分析影响重型颅脑损伤患者伤后3个月肢体运动功能及肌力的因素。结果患者受伤后3个月的FMA评分高于意识清醒时,差异均有统计学意义(P<0.05)。受伤后3个月的Lovett肌力分级为5级患者所占比例高于意识清醒时,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示:年龄、昏迷时间、早期康复治疗情况是患者受伤后3个月FMA评分的独立影响因素(P<0.05);昏迷时间、早期康复治疗情况是患者受伤后3个月Lovett肌力分级的独立影响因素(P<0.05)。结论年龄、昏迷时间、早期康复治疗情况是影响重型颅脑损伤患者受伤后3个月肢体运动功能、肢体肌力的主要因素。临床上应尽力缩短患者的昏迷时间,早期实施康复治疗,以改善患者肌力及预后。

Objective This study aimed to investigate the influencing factors of limb motor function and muscle strength in patients with severe craniocerebral injury 3 months after injury to provide evidence for clinical treatment.Methods A total of 93 patients with severe craniocerebral injuries admitted to Jiaozuo People's Hospital from March 2021 to December 2021 were selected as the study participants.General data concerning patients were collected.The Fugl-Meyer assessment(FMA)scale was used to assess limb motor function when the patient was conscious at 3 months after injury;the Lovett muscle strength classification was employed to assess muscle strength when the patient was conscious at 3 months after injury.Multivariate logistic regression was used to analyze the influencing factors of limb motor function and muscle strength 3 months after injury in patients with severe head injuries.Results The FMA score at 3 months after injury was significantly higher than that in a conscious state(P<0.05).The proportion of patients with Lovett muscle strength grade 5 at 3 months after injury was significantly higher than that during consciousness(P<0.05).The results of multivariate logistic regression analysis showed that age,duration of coma,and early rehabilitation were independent factors of FMA score 3 months after injury(P<0.05);duration of coma and early rehabilitation were independent factors of Lovett muscle strength grade 3 months after injury(P<0.05).Conclusion Age,duration of coma,and early rehabilitation are the main factors affecting limb motor function and limb muscle strength in patients with severe head injuries 3 months after injury.In clinical practice,efforts should be made to shorten the duration of coma in patients,conduct rehabilitation treatment in the early stage,and improve the prognosis of muscle strength.