占小燕 余國(guó)峰

[摘要] 目的 探討早期評(píng)估與分級(jí)管理康復(fù)模式對(duì)重型顱腦損傷患者的干預(yù)效果。 方法 回顧性分析我院在2016年8月～2018年4月期間收治的128例重型顱腦損傷患者，隨機(jī)分為兩組，給予對(duì)照組患者常規(guī)干預(yù)，給予研究組患者早期評(píng)估與分級(jí)管理康復(fù)模式干預(yù)。觀察比較兩組患者的生活質(zhì)量水平及康復(fù)干預(yù)期間的生活自理能力和綜合功能的康復(fù)水平。 結(jié)果 研究組患者的生活質(zhì)量水平明顯優(yōu)于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;研究組患者的生活自理能力以及綜合功能的康復(fù)水平明顯優(yōu)于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。 結(jié)論 重型顱腦損傷患者應(yīng)用早期評(píng)估與分級(jí)管理康復(fù)模式進(jìn)行干預(yù)具有良好的干預(yù)效果，不僅可以改善患者的生活自理能力，還可以提高患者的綜合功能康復(fù)水平，值得在臨床上進(jìn)一步推廣和應(yīng)用。

[關(guān)鍵詞] 早期評(píng)估;分級(jí)管理;康復(fù)模式;重型顱腦損傷;干預(yù)效果

[中圖分類號(hào)] R651.15? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] B? ? ? ? ? [文章編號(hào)] 1673-9701（2019）18-0128-04

[Abstract] Objective To explore the effect of early assessment and graded management rehabilitation model on patients with severe craniocerebral injury. Methods A retrospective analysis was performed on 128 patients with severe head injury who were admitted to our hospital between August 2016 and April 2018. These patients were randomized into two groups. Patients in the control group were given routine intervention， and patients in the study group were intervened according to the early assessment and graded management rehabilitation model. The quality of life， self-care ability and comprehensive function rehabilitation level of the two groups of patients were observed and compared. Results The quality of life of the study group was significantly better than that of the control group（P<0.05）. The self-care ability and comprehensive function of the study group were significantly better than those of the control group（P<0.05）. Conclusion For patients with severe craniocerebral injury， the early assessment and graded management rehabilitation mode has a good intervention effect， which not only can improve the patients self-care ability， but also improve the rehabilitation level of the patients comprehensive function， which is worthy of further promotion and application in the clinic.

[Key words] Early assessment; Graded management; Rehabilitation mode; Severe craniocerebral injury; Intervention effect

重型顱腦損傷是神經(jīng)科疾病常見(jiàn)的一種類型，具有較高的致殘率和致死率，且臨床上預(yù)后性較差，并發(fā)癥率較高[1]。顱腦損傷根據(jù)患者的昏迷時(shí)間、陽(yáng)性體征和生命體征可分為輕、中、重型，重型則是最嚴(yán)重的一種顱腦損傷[2]。大多數(shù)重型顱腦損傷患者均會(huì)存在不同程度的肢體運(yùn)動(dòng)障礙，會(huì)對(duì)生活的自理能力造成嚴(yán)重的影響，通過(guò)早期的護(hù)理干預(yù)，可有效降低致殘率，提高生活質(zhì)量水平。臨床上對(duì)于重型顱腦損傷患者的康復(fù)干預(yù)常采用常規(guī)護(hù)理干預(yù)模式，但是其干預(yù)效果并不顯著[3]，本文旨在探討早期評(píng)估與分級(jí)管理康復(fù)模式對(duì)重型顱腦損傷患者的干預(yù)效果的影響，現(xiàn)報(bào)道如下。

1 資料與方法

1.1一般資料

回顧性分析我院在2016年8月～2018年4月期間收治的128例重型顱腦損傷患者，采用隨機(jī)數(shù)字表法將其分為兩組，每組各64例。對(duì)照組男39例，女25例，年齡19～65歲，平均（38.5±2.3）歲;研究組男38例，女26例，年齡18～65歲，平均（38.8±2.5）歲。納入標(biāo)準(zhǔn)：（1）通過(guò)CT或者磁共振確診為顱內(nèi)損傷;（2）根據(jù)患者的臨床癥狀判斷為重型顱腦損傷;（3）意識(shí)清醒且病情穩(wěn)定;（4）精神正常且可以配合治療;（5）自愿參與本次研究[4]。排除標(biāo)準(zhǔn)：（1）具有嚴(yán)重的認(rèn)知功能障礙者;（2）肝腎功能等臟器器官存在異常者;（3）不愿意參與本次研究者;（4）具有嚴(yán)重的心肺功能不全[5]者。兩組患者的一般資料比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05），具有可比性，并經(jīng)過(guò)醫(yī)院倫理委員會(huì)批準(zhǔn)。