CAJ | 학술논문

目的了解和分析创伤性颅脑损伤(TBI)患儿的康复治疗概况及其预后情况,以探讨合理的康复评定及其治疗措施.方法回顾性分析温州医学院附属第二医院康复医学科2006年1月至2011年5月首次入院行康复治疗的64例TBI患儿的一般临床情况及其康复治疗情况、意识状态、日常生活活动(ADL)能力恢复情况、总体康复疗效及其影响因素等.结果 ①住院康复治疗的TBI患儿颅脑损伤以重型颅脑损伤为主(66％),意识障碍者占42.19％,肢体运动障碍型患儿以偏瘫为主(51.67％),主要(65.63％)在伤后1个月内行康复干预；平均住院日为(33.09±25.96)d,意识障碍者住院时间比无意识障碍者长(P＜0.05)；治疗措施以高压氧、运动疗法和营养神经药物为主(分别占95.31％、89.06％和82.81％)；②经首次住院康复治疗后患儿苏醒率达81.48％,ADL有显著改善(P＜0.01),总有效率达90.63％；③单因素和多因素分析均显示,年龄小和康复介入时间迟是影响近期康复效果的2个不良因素.结论综合康复治疗可有效改善创伤性颅脑损伤患儿意识状态,促进运动功能恢复,提高生活自理能力,受伤年龄越大,康复介入时间越早,近期康复结局越好.
목적 료해화분석창상성로뇌손상(TBI)환인적강복치료개황급기예후정황,이탐토합리적강복평정급기치료조시.방법 회고성분석온주의학원부속제이의원강복의학과2006년1월지2011년5월수차입원행강복치료적64례TBI환인적일반림상정황급기강복치료정황、의식상태、일상생활활동(ADL)능력회복정황、총체강복료효급기영향인소등.결과 ①주원강복치료적TBI환인로뇌손상이중형로뇌손상위주(66％),의식장애자점42.19％,지체운동장애형환인이편탄위주(51.67％),주요(65.63％)재상후1개월내행강복간예；평균주원일위(33.09±25.96)d,의식장애자주원시간비무의식장애자장(P＜0.05)；치료조시이고압양、운동요법화영양신경약물위주(분별점95.31％、89.06％화82.81％)；②경수차주원강복치료후환인소성솔체81.48％,ADL유현저개선(P＜0.01),총유효솔체90.63％；③단인소화다인소분석균현시,년령소화강복개입시간지시영향근기강복효과적2개불량인소.결론 종합강복치료가유효개선창상성로뇌손상환인의식상태,촉진운동공능회복,제고생활자리능력,수상년령월대,강복개입시간월조,근기강복결국월호.
Objective To investigate the rehabilitation prognoses of children with traumatic brain injury (TBI).Methods A retrospective analysis was made in 64 children who had been admitted for rehabilitation.Their clinical information,rehabilitation protocols,recovery of consciousness and ability in the activities of daily living (ADL) were analyzed. Results The children's injuries were severe-42.19％ had consciousness disorders,but 80％ of them recovered consciousness after rehabilitation.Their limb motor dysfunction was dominated by hemiplegia (51.67％).For 65.63％ of the patients rehabilitation was initiated within one month after injury.The average length of stay in rehabilitation was 33.09 ± 25.96 days.Those with consciousness disorders stayed significantly longer than those without.The main treatments were hyperbaric oxygen therapy,exercise and neurotrophic drugs (the ratios were 95.31％,89.06％ and 82.81％ respectively).After the first course of inpatient rehabilitation,the conscious ness recovery rate was 81.48％ and ADL ability improved significantly.The total effectiveness rate was 90.63％.Univariate and multivariate analyses showed that the factors most strongly correlated with effective rehabilitation were age at injury and the rehabilitation intervention time.Conclusion The results suggest that a general hospital should focus on early (acute and subacute phase) rehabilitation.So developing the rehabilitation network system is necessary and urgent.Rehabilitative therapy is very helpful in TBI cases.Being older at the time of injury and earlier rehabilitation intervention predict better short term outcomes.It is necessary to build and improve on a more standardized and systemic rehabilitation and assessment system for pediatric TBI.