重型闭合性颅脑损伤患者的康复临床研究

目的：研究重型闭合性颅脑损伤住院患者综合康复治疗的效果以及影响因素。方法：对住院的69例重型颅脑损伤患者进行综合康复治疗，采用Glasgow昏迷量表（GCS）、日常生活能力（ADL）、残疾分级量表（DRS）、简易精神状态检查表（MMSE）等评定疗效并进行统计学分析。结果：本组病例的年龄、病程、治疗时间、GCS、昏迷时间等均有较大差异，其中GCS评分明显受昏迷时间的影响（P＜0．001）；患者的日常生活能力、认知能力和残疾水平均有较大程度的改善（P＜0．001）；手术组认知功能的恢复较非手术组明显（P＜0．05）；日常生活能力的恢复主要受损伤严重程度（GCS评分）和治疗时间的影响（P＜0．05）；认知功能的恢复除受GCS影响外（P＜0．01），病程短恢复好（P＜0．05）。结论：临床综合康复治疗对于重型闭合性颅脑损伤患者各种功能的恢复具有肯定的效果，日常生活能力和认知能力的恢复受颅脑损伤程度的影响、脑损伤患者认知功能的康复体系有待加强。

Clinical study on the rehabilitation of patients with severe closed traumatic brain injury

Objective: To investigate the outcome and the influence factors of the combined rehabilitation treatments on the inpatients with severe closed traumatic brain injury. Method: Sixty-nine inpatients with severe closed traumatic brain injury were treated by combined rehabilitation therapy and assessed with Glasgow coma scale(GCS), Disability rating scale (DRS), ADL, Mini-mental status examination (MMSE). The assessed results before and after the treatment were analyzed statistically. Result: The age, course of injury, treatment time, GCS and coma time of the patients were various. GCS and coma time showed a negative correlation ( P <0.001). ADL, cognitive ability and DRS of the patients were improved obviously after the treatment. MMSE of post-operation group was improved more obviously than non-operation group. Recovery of ADL was influenced mainly by GCS and treatment time ( P <0.05). Recovery of MMSE was influenced mainly by GCS ( P <0.01) and course of injury ( P <0.05). Conclusion: The combined rehabilitation treatments on the inpatients with severe closed traumatic brain injury were functionally effective. The recovery of ADL and MMSE were mainly influenced by GCS. The system of cognitive rehabilitation should be improved.