颅脑损伤患者康复疗效影响因素分析

目的分析影响创伤性颅脑损伤颅脑损伤（TB0患者肢体运动功能、日常生活活动能力恢复的因素。方法康复治疗前后对145例TBI患者采用运动功能评定量表、改良巴氏指数进行运动功能及日常生活活动能力评定，观察康复治疗效果；以康复治疗3个月末评定结果为因变量，记录患者治疗期间各种相关影响因素，应用多因素Logistic回归分析方法分析患者预后与各相关因素的关系。结果康复治疗3个月末，患者运动功能及日常生活活动能力有明显提高（P〈0．01），影响TBI患者运动功能及日常生活活动能力的有利因素为早期康复介入、2／d的康复训练；抑郁状态是影响患者运动功能及日常生活活动能力的不利因素，认知功能障碍也是影响患者日常生活活动能力的不利因素。结论多种相关因素影响TBI患者康复治疗的疗效，早期进行综合康复治疗，有效改善患者认知功能、治疗抑郁状态，并及时进行康复训练可明显提高患者的预后。

Factors related to rehabilitation prognosis of patients with traumatic brain injury

Objective To investigate the factors related to prognosis （recovery of motor, activities of daily living） of patients with traumatic brain injury （TBI）. Methods 145 patients with medium and severe TBI were assessed with Fugl-Meyer Acessment, modified Barthel index before and after treatment. The scores of 3 months later were as the dependent variable respectively,and various related factors were recorded. The relationship between each patient＇s prognosis and the related factors were analyzed through multivariate Logistic regression. Results The positive factors for motor function and ADL scores after rehabilitation were early intervention and exercise twice a day. The negative factor is depression. Cognition was found to be correlated with ADL score. Conclusion Certain factors predict the rehabilitation prognosis of patients TBI. Early and frequent rehabilitation on patients with TB1 might obviously improve motor function and the activities of daily living. Improving cognitive function and treating depression would benefit patients＇ prognosis.