颅脑损伤健康相关生命质量的影响因素分析

目的 探讨颅脑损伤（TBI）健康相关生命质量（HRQOL）的影响因素。方法 从2013年8月至2015年2月第三军医大学大坪医院神经外科就诊的TBI中随机抽取234例，采用抑郁自评量表（SDS）评估抑郁状态，采用SF-36量表评估HRQOL，采用多元逐步线性回归法分析HRQOL的影响因素。结果 SDS评分结果显示抑郁症状221例（94.4%）。统计分析结果显示SDS评分、GCS评分、年龄、性别、继续治疗、文化程度、婚姻状况、锻炼、收入、医保类型、颅内出血显著影响HRQOL评分。结论 重视高龄、女性、低学历、无伴侣、低收入、无医保TBI患者，尤其注意低GCS评分、颅内出血患者，鼓励患者定期随访和心理疏导，加强锻炼，可显著改善TBI患者HRQOL评分。

Investigation on health-related quality of life and influencing factors in patients with traumatic brain injury

Objective To analysis the depressive state, health-related quality of life (HRQOL) and factors influencing them in patients with traumatic brain injury (TBI). Methods The degrees of depression and HRQOL were assessed respectively by self-rating depression scale (SDS) and short form 36 questionnaire (SF-36) in 234 patients with TBI. The general situation and medical records information were analyzed in all the patients. Results Of 234 patients with TBI, 221 (94.4%) had depressive symptoms and 13 not. The stepwise regression analysis showed that the factors influencing HRQOL scores included SDS, GCS, age, sex, continue treatment, educational level, marital status, physical exercise, income and medical insurance type and intracranial hemorrhage in the patients with TBI. Conclusions The results suggested that more attention must be paid to elderly, female, low educational level, singleness, low income, no health care, low GCS and intracranial hemorrhage patients with TBI because they more easily suffered from depression after TBI. The regular follow-up, psychological counsel and physical exercise should be encouraged and strengthened. These measures can significantly improve the HRQOL in the patients with TBI.