《中国康复理论与实践》

《中国康复理论与实践》 ›› 2010, Vol. 16 ›› Issue (10): 966-968.

• 论文 • 上一篇    下一篇

不同病程脑外伤患者康复治疗的成本-疗效分析

张皓，张小年，王晓艳，孙新亭，迟茜茜   

  1. 中国康复研究中心北京博爱医院神经康复科，北京市 100068。
  • 收稿日期:2010-07-19 修回日期:1900-01-01 出版日期:2010-10-25 发布日期:2010-10-25

Cost-Effectiveness Analysis of Rehabilitation of Traumatic Brain Injury at Different Stages

ZHANG Hao, ZHANG Xiao-nian, WANG Xiao-yan, et al   

  1. Capital Medical University School of Rehabilitation Medicine, Beijing Charity Hospital, China Rehabilitation Research Center, Beijing 100068, China
  • Received:2010-07-19 Revised:1900-01-01 Published:2010-10-25 Online:2010-10-25

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摘要： 目的考察不同病程脑外伤患者1个疗程的正规康复治疗效果，统计不同病程脑外伤患者1个疗程的康复费用，探讨康复介入的时机和不同病程阶段的康复重点。方法250例脑外伤患者按入院时病程分为5个组：<3个月、3～6个月、6个月～1年、1～2年、>2年，每位患者入院时进行临床资料登记和初始功能的评定，且进行至少1个疗程的正规康复治疗后再进行功能评定；分析不同病程脑外伤患者1个疗程住院康复的成本及效果；并进行经济学分析。结果随着病程延长，第1个疗程康复的成本-疗效比有逐渐升高的趋势。第2个疗程较第1个疗程的成本-疗效比明显增加；脑外伤发病后12个月内介入康复，应行全面的康复治疗，同时应积极预防和处理脑积水等并发症；1～2年内介入康复，下肢功能、平衡能力不会有明显改善，应以加强日常生活活动能力(ADL)和上肢功能训练为主；2年后介入康复，则只能利用残存功能，提高ADL。结论脑外伤后需尽早进行康复治疗，且需根据患者病程实施相应的重点内容训练。

关键词: 脑外伤, 康复, 疗程, 疗效, 经济学

Abstract: ObjectiveTo study the effect of a course of regular rehabilitation treatment on patients with different traumatic brain injury(TBI) course, explore the costs of one rehabilitation course in patients with different TBI course, and study the timing and focus of rehabilitation on patiens with different stages.Methods250 TBI patients were distributed to five groups by different TBI courses: <3 months, 3～6 months, 6 months～1 year, 1～2 years and >2 years. The clinical data and initial function evaluation were done at the admission. All of them received at least one regular rehabilitation treatment, then another function evaluation was done. Effects and costs of one rehabilitation course in patients with different TBI course were investigated.ResultsThe longer the duration of illness, the higher the cost-effectiveness ratio. The cost-effectiveness ratio of the second treatment course was higher than the first one. The patients within 12 months should receive a comprehensive rehabilitation treatment, and should be prevented and treated hydrocephalus and other complications; for patients within 1～2 years, there would be no significant improvement in balance and lower limb function, should enhance the training of activity of daily living (ADL) and upper extremity function; for the patients more than two years just improved ADL using of residual function.ConclusionTBI patients should accept rehabilitation as soon as possible, and should be conducted corresponding trainings according to different disease course.

Key words: traumatic brain injury, rehabilitation, course, therapeutic effect, econmics