颅脑创伤患者的后期康复

The quality of life in traumatic brain injury patients

目的 观察颅脑创伤患者治疗效果、后期康复情况及不同时期生活质量。方法 使用自行设计的改良功能生活指数(revised functional living index,RFLI)量表,对122例颅脑创伤恢复期患者进行生活质量评估,其中85例获随访结果。由患者自己填写RFLI量表,并与GCS、GOS和KPS等量表进行比较。结果 经多因素回归分析显示,RFLI与GCS、GOS、KPS之间均存在明显相关性,r值分别为0.525 6、0.546 6、0.489 1(P<0.001)。RFLI得分越高,患者的综合性生活适应能力越强,即整体康复水平越高。结论 颅脑创伤患者伤后的生活质量与其主观感觉存在显著相关性。在治疗患者生理疾病的同时,应保持其心理健康,并促进其认知功能的恢复。

Objective The quality of life (QOL) in traumatic brain injury (TBI) patients was evaluated by a new assessment device with revised functional living index (RFLI) . Methods From 1997 to 1998, a total of 122 TBI patients treated in Department of Neurosurgery, Beijing Tiantan Hospital were included in this study. All patients were grouped by their gender, age, Glasgow coma scale(GCS) score and treatment methods respectively. Their scores with Glasgow outcome scale (COS) , Karnofsky performance scale (KPS) and RFLI were observed during admission and after discharging. The RFLI consisted of 20 questions, the score of each question ranged from 1 to 5 according to the answer judged by the patients themselves. These questions were designed to analyze the physical, psychological, cognitive and social ability, respectively. Until Feb 2000, detailed follow -up results with an average period of 2 - 3 years were obtained in 85 patients. All these data were analyzed statistically . Results The RFLI score was not only closely correlated with GCS,GOS and KPS significantly, but also reflected the long term recovery of TBI patients. Conclusion The application of multifunctional evaluation reflecting physical, psychosocial and cognitive abilities was proved to be effective in assessing the QOL of TBI patients .