CAJ | 학술논문

目的：探讨在颅脑创伤单元模式下对偏瘫患者进行分期康复训练的效果。方法选取2012年6月-2013年5月收治的颅脑损伤并发偏瘫患者120例，其中选取60例常规治疗模式患者为对照组，建立颅脑创伤单元模式后选取60例为观察组。入院24 h内及5周后分别行格拉斯哥昏迷量表（GCS）、改良的Rankin量表（MRS）、Barthel指数（BI）评分。两组均接受一般神经外科常规治疗，对照组采用常规护理；观察组采用颅脑创伤单元模式下的分期康复指导。结果两组患者治疗前后GCS、MRS、BI 3个方面评分差异均有统计学意义，治疗后观察组 GCS、MRS、BI 分别为（8．25±5．01），（3．49±2．13），（45．84±15．48）分，优于对照组治疗后（10．21±4．11），（3．00±1．24），（54．72±17．74）分，差异有统计学意义（t值分别为2．343，2．074，2．922；P＜0．05）。干预组BI＞65分比例为65．0％、回家自理者占70．0％，均高于对照组（40．0％，41．7％），两组比较差异有统计学意义（χ2值分别为7．519，9．766；P＜0．01）。结论在颅脑创伤单元模式中，更强调医护联合，护士进行专业康复指导，保证了患者在入院时即开始正规康复治疗，为日后进一步系统的康复治疗做好准备，最大限度避免影响预后不良事件的发生，使患者在病情稳定之后，能够顺利进入下一阶段的康复治疗，缩短急性期住院时间，改善康复预后，使患者获得最大限度的功能恢复。
목적：탐토재로뇌창상단원모식하대편탄환자진행분기강복훈련적효과。방법선취2012년6월-2013년5월수치적로뇌손상병발편탄환자120례，기중선취60례상규치료모식환자위대조조，건립로뇌창상단원모식후선취60례위관찰조。입원24 h내급5주후분별행격랍사가혼미량표（GCS）、개량적Rankin량표（MRS）、Barthel지수（BI）평분。량조균접수일반신경외과상규치료，대조조채용상규호리；관찰조채용로뇌창상단원모식하적분기강복지도。결과량조환자치료전후GCS、MRS、BI 3개방면평분차이균유통계학의의，치료후관찰조 GCS、MRS、BI 분별위（8．25±5．01），（3．49±2．13），（45．84±15．48）분，우우대조조치료후（10．21±4．11），（3．00±1．24），（54．72±17．74）분，차이유통계학의의（t치분별위2．343，2．074，2．922；P＜0．05）。간예조BI＞65분비례위65．0％、회가자리자점70．0％，균고우대조조（40．0％，41．7％），량조비교차이유통계학의의（χ2치분별위7．519，9．766；P＜0．01）。결론재로뇌창상단원모식중，경강조의호연합，호사진행전업강복지도，보증료환자재입원시즉개시정규강복치료，위일후진일보계통적강복치료주호준비，최대한도피면영향예후불량사건적발생，사환자재병정은정지후，능구순리진입하일계단적강복치료，축단급성기주원시간，개선강복예후，사환자획득최대한도적공능회복。
Objective To explore the effectiveness of traumatic brain model on the rehabilitation hemiplegic patients .Methods From June 2012 to May 2013 , 120 cases with craniocerebral injury complicated with hemiplegia were selected .60 patients with conventional treatment were in the control group . After established the traumatic brain model , 60 cases were selected for the observation group .Within 24 hours admitted in the hospital and 5 weeks after admission, the Glasgow coma scale (GCS), modified Rankin scale (MRS) and the Barthel index (BI) were surveyed.Two groups were given the routine neurosurgery therapy . The control group was given the conventional care , while the observation group was used the traumatic brain model for the rehabilitation guidance .Results The SCS, MRS and BI scores between groups before and after treatment had significant differences .After the treatment , the scores of SCS , MRS and BI in the observation group were (8.25 ±5.01), (3.49 ±2.13), (45.84 ±15.48), which were significantly higher than (10.21 ± 4.11), (3.00 ±1.24), (54.72 ±17.74) in the control group (t=2.343,2.074,2.922,respectively;P<0.05).The proportion of BI >65, self care were 65.0% and 70.0% in the observation group, which were significantly higher than 40.0% and 41.7% in the control group (χ2 =7.519, 9.766, respectively;P <0.01).Conclusions The traumatic brain model emphasizes the partnership between neuro-surgeons and rehabilitation specialists .Meanwhile, the nurses will give the professional guidance on rehabilitation .All these can guarantee a timely rehabilitation treatment for the patients after their admission to the hospital , which can also provide a solid foundation for further rehabilitation .It avoids the occurrences of adverse events to the uttermost and paves the way for the rehabilitation treatment in the next phase after the patients in a stable condition , which can reduce the time of hospital stays , improve the rehabilitation prognosis and help the patients with the functional recovery to the greatest extent .