《中国康复理论与实践》

《中国康复理论与实践》 ›› 2018, Vol. 24 ›› Issue (9): 1114-1116.doi: 10.3969/j.issn.1006-9771.2018.09.026

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脑损伤后意识障碍患者的感觉模式评估与康复技术(SMART)简介

张一1, 张皓2,3, 芦海涛2,3, 张小年2,3, 张瑜1   

  1. 1.江苏省常州市第一人民医院康复科,江苏常州市 213000;
    2.中国康复研究中心北京博爱医院神经康复科,北京市 100068;
    3.首都医科大学康复医学院,北京市 100068
  • 收稿日期:2018-06-29 修回日期:2018-08-09 出版日期:2018-09-20 发布日期:2018-09-27
  • 通讯作者: 张皓。E-mail: zh1665@163.com
  • 作者简介:张一(1975-),男,汉族,江苏常州市人,博士,主任医师,主要研究方向：神经康复。通讯作者：张皓(1965-),女,汉族,北京市人,博士,主任医师、教授,硕士研究生导师,主要研究方向：神经康复。

Sensory Modality Assessment and Rehabilitation Technique (SMART) for Disorders of Consciousness after Brain Injury

ZHANG Yi1, ZHANG Hao2,3, LU Hai-tao2,3, ZHANG Xiao-nian2,3, ZHANG Yu1   

  1. 1. Department of Rehabilitation, the First People's Hospital of Changzhou, Changzhou, Jiangsu 213000;
    2. Department of Neurology Rehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China;
    3. Capital Medical University School of Rehabilitation Medcine, Beijing 100068, China
  • Received:2018-06-29 Revised:2018-08-09 Published:2018-09-20 Online:2018-09-27
  • Contact: ZHANG Hao. E-mail: zh1665@163.com

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摘要： 感觉模式评估与康复技术(SMART)作为评估脑损伤后意识障碍的工具之一,旨在检测意识障碍患者意识存在的迹象和有意义的反应,并通过制定治疗计划,优化患者的潜在沟通和运动功能,可以用于意识障碍患者的评估、治疗以及长期预后判断。SMART能够有效降低意识障碍误诊率,原因在于优化评估前环境、长时间的观察评估、评估中纳入家属和照顾团队,以及评估内容的标准化。SMART除了是一个评估工具外,还提供治疗方案。目前SMART治疗阶段已经正式化,可以为患者创建个性化治疗计划。意识障碍评估后的干预可以分为探索、加强和教育。SMART量表在评估、治疗、预后判定方面均有其独特的优势,相信在国内推广应用能够进一步规范意识障碍的诊断和干预。

关键词: 意识障碍, 评定, 康复, 感觉模式评估与康复技术

Abstract: Sensory Modality Assessment and Rehabilitation Technique (SMART) is one of the tools for assessing patients with disorders of consciousness (DOC) after brain injury, to detect signs and meaningful responses to the conscious presence of DOC patients, and to optimize the patient's potential communication and motor function through the development of a treatment plan, that can be used in the assessment, treatment, and long-term prognosis of patients with DOC. SMART can effectively reduce the misdiagnosis of DOC due to the environment, long observation and evaluation, the incorporation of family and care teams in the evaluation, and the normalization of the evaluation content. Besides an assessment tool, SMART provides treatment options. At present, the SMART treatment stage has been formalized, which can create personalized treatment plan for patients. The intervention after DOC evaluation can be divided into exploration, strengthening and education. SMART is advantaged in evaluation, treatment and prognosis, that can benefit the standardization of diagnosis and intervention of DOC in China.

Key words: disorders of consciousness, assessment, rehabilitation, Sensory Modality Assessment and Rehabilitation Technique

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