作者：贾萍，孟雨亭，于德洋，卢灿

单位：

210000江苏省南京市，南京医科大学附属明基医院高压氧科

Units：

Department of Hyperbaric Oxygen, the Affiliated BenQ Hospital of Nanjing Medical University, Nanjing 210000, China

关键词：

脑损伤，创伤性；康复；运动功能；眩晕；姿势平衡

Keywords：

Brain injuries, traumatic; Rehabilitation; Motor function; Vertigo; Postural balance

CLC：

R 651.15

DOI：

10.12114/j.issn.1008-5971.2024.00.007

Funds：

江苏省卫生健康委员会科研项目（20210171）

摘要：

目的　探讨早期强化康复治疗对创伤性脑损伤（TBI）患者运动功能、眩晕、平衡能力的影响。方法 本研究共招募2020—2021年入住南京医科大学附属明基医院神经外科的70例TBI患者为研究对象。通过计算机软件 系统生成随机数后采用信封法将患者分配到A组或B组，每组35例。A组患者接受早期强化康复治疗，B组患者接受常 规康复治疗，两组均干预4周。比较两组干预前及干预后1、3、6个月Fugl-Meyer运动功能评估量表（FMA）评分， 干预后1、3、6个月格拉斯哥预后量表（GOS）评分、Barthel指数（BI）评分，干预前及干预后1、3、6个月眩晕残障 程度评定量表（DHI）评分和平衡误差评分系统（BESS）评分。结果　干预方法与时间在FMA评分、GOS评分、BI 评分上存在交互作用（P＜0.05）；干预方法、时间在FMA评分、GOS评分、BI评分上主效应显著（P＜0.05）；干预 后3、6个月，A组FMA评分高于B组（P＜0.05）；干预后6个月，A组GOS评分、BI评分高于B组（P＜0.05）。干预方 法与时间在DHI评分、BESS评分上存在交互作用（P＜0.05）；干预方法、时间在DHI评分、BESS评分上主效应显著 （P＜0.05）；干预后1、3、6个月，A组DHI评分、BESS评分低于B组（P＜0.05）。结论　早期强化康复治疗能有效提 高TBI患者运动功能和日常生活活动能力，并有助于缓解其眩晕及平衡障碍。

Abstract：

Objective To investigate the effect of early intensive rehabilitation on motor function, vertigo and balance ability in patients with traumatic brain injury (TBI) . Methods In this study, a total of 70 TBI patients admitted to the Department of Neurosurgery, BenQ Medical Center Affiliated to Nanjing Medical University from 2020 to 2021 were recruited as the study subjects. After the random number was generated by the computer software system, the patients were assigned to group A or group B by envelope method, with 35 cases in each group. Patients in group A received early intensive rehabilitation treatment, and patients in group B received routine rehabilitation treatment. Both groups were intervened for 4 weeks. The Fugl-Meyer Motor Assessment (FMA) score before intervention and at 1, 3 and 6 months after intervention, the Glasgow Outcome Scale (GOS) score and Barthel Index (BI) score at 1, 3 and 6 months after intervention, and the Dizziness Handicap Inventory (DHI) score and Balance Error Scoring System (BESS) score before intervention and at 1, 3 and 6 months after intervention were compared between the two groups. Results There was an interaction between intervention method and time in FMA score, GOS score and BI score (P < 0.05) . The main effects of intervention methods and time on FMA score, GOS score and BI score were significant (P < 0.05) . At 3 and 6 months after intervention, the FMA score of group A was higher than that of group B (P < 0.05) . At 6 months after intervention, the GOS score and BI score of group A were higher than those of group B (P < 0.05) . There was an interaction between intervention method and time in DHI score and BESS score (P < 0.05) . The main effects of intervention methods and time on DHI score and BESS score were significant (P < 0.05) . At 1, 3 and 6 months after intervention, the DHI score and BESS score of group A were lower than those of group B (P < 0.05) . Conclusion Early intensive rehabilitation therapy can effectively improve the motor function and activities of daily living of TBI patients, and help to alleviate their vertigo and balance disorders.

ReferenceList：