不同病程创伤性颅脑损伤患者运动功能康复效果的回顾性分析

目的：探讨创伤性颅脑损伤后不同时期介入康复治疗对患者运动功能及日常生活活动能力的疗效影响。方法：对163例创伤性颅脑损伤患者的临床资料进行回顾性分析。根据康复治疗介入的时间（〈3个月、3-6个月、6-12个月、1-2年、〉2年）将患者分为5组，于治疗前及治疗2个月后评定患肢的运动功能、ADL能力及步行能力。结果：康复治疗介入时间〈3个月组和3—6个月组的患者上下肢及手的运动功能、步行能力和ADL均有显著提高（P〈0．05）；6-12个月组的患者除步行能力无明显改善外，其余功能均有显著提高（P〈0．05）；1-2年组的患者其上肢功能和ADL能力均有显著提高（P〈0．05），但其余功能均无提高；而〉2年组的患者只有ADL能力有显著提高（P〈0．05）．结论：系统正规的康复治疗有利于创伤性颅脑损伤后不同时期康复的患者。康复医师应根据康复介入的时间，确定康复治疗的重点。

The effect of rehabilitation treatment on the motor function at different period after traumatic brain injury

Objective:To observe the effect of the rehabilitation treatment on the motor function and activities of daily living(ADL) at different period after traumatic brain injury.Method:163 inpatients with traumatic brain injury were retrospectively analyzed. The patients were divided into five groups according to the disease course(<3months,3-6 months,6-12months,1-2years and >2years). Two months before and after rehabilitation treatment,the motor function of the involved limb,ADL and ambulation were assessed.Result:After treatment the motor function of upper and lower limbs and hands,ambulation and ADL of <3months group and 3-6months group were improved(P<0.05). Except the ambulation,6-12 months group was also improved(P<0.05). The function of upper limbs and ADL of 1-2 years group was improved(P<0.05). In >2years group only ADL was improved. Conclusion:Rehabilitation treatment has benefit for TBI patients in different periods. The treatment emphasis should vary with the beginning time of rehabilitation treatment.