FIM量表在外伤性颅脑损伤患者康复疗效评价中的应用

目的 :运用功能独立性评价量表 (FIM )评价外伤性颅脑损伤 (TBI)患者的康复治疗疗效 ,比较闭合性颅脑损伤 (CBI)和开放性颅脑损伤 (OBI)患者的临床特点和康复治疗的效果。方法 :79例TBI患者中 ,5 7例为CBI、2 2例为OBI。运用FIM量表评价两组患者康复治疗前后的功能情况 ,统计患者的入院天数 ,计算FIM效率。结果 :CBI和OBI患者入院时的FIM总评分分别为 81.5 1和 73.0 9;出院时FIM总评分分别为 115 .0 4和 117.77,两组平均增加 4 1%和 5 3%。两组患者康复治疗前后FIM各项评分自身相比有非常显著差异 (P <0 .0 0 1) ,但两组之间相比无显著差异。两组患者的FIM效率分别为 1.99分 /天和 1.71分 /天。结论 :康复治疗可有效改善TBI(无论是CBI还是OBI)患者的功能情况。康复治疗应强调早期和综合性治疗

Functional independence measure in use of evaluating the outcome in rehabilitation of traumatic brain injury patients

Objective: To evaluate the rehabilitation outcome of traumatic brain injury (TBI) patients using the Functional Independence Measure (FIM), and compare the injury characteristics, as well as functional outcomes of patients with closed brain injury (CBI) verses opened brain injury (OBI). Method:79 patients with TBI entered into the data set, including 57 patients with CBI and 22 patients with OBI. Main outcome measures included FIM scores both on admission and discharge, change in FIM scores, length of rehabilitation stay (LOS), onset to rehabilitation day, and FIM efficiency. Result:The admission FIM scores of CBI and OBI were 81.51 and 73.09, respectively. The discharge FIM scores of CBI and OBI were 115.07 and 117.77 for each group. The average progress of both groups was 41% and 53% for CBI and OBI. There were significant differences in discharge scores compared with admission scores for every item on the FIM scores (P<0.001). There were no significant differences noted, however, between the two groups. The FIM efficiency was 1.99/day and 1.71/day for CBI and OBI. Conclusion: Both CBI and OBI patient groups showed multiple functional impairments. The rehabilitation resulted in functional improvement of both groups of patients. Both groups could achieve comparable recovery of function and improved rates of FIM score. It should be emphasized for TBI patients that an early and comprehensive rehabilitation program results in improved outcome.