规范化康复单元对脑外伤的效果

doi:10.3969/j.issn.1006-9771.2026.09.005

Abstract

Abstract:

Objective To establish three standardized rehabilitation unit models covering acute, critical and comprehensive recovery stages for traumatic brain injury (TBI) that fit the whole-course characteristics, clarify their multidisciplinary collaborative framework, standardized procedures, and information management system, and verify the clinical effectiveness of this staged rehabilitation unit on long-term functional prognosis and in-hospital complications of TBI patients.

Methods This study was conducted at two stages: model construction and efficacy verification. At the first stage, TBI rehabilitation units for acute, critical and recovery stages were established in the Department of Neurosurgery, Intensive Care Unit and Department of Rehabilitation Medicine, respectively, with unified multidisciplinary team configuration, standardized assessment and treatment protocols, collaborative workflows, and a dedicated information management system. At the second stage, 324 TBI patients admitted to the newly built rehabilitation units from July, 2023 to July, 2025 were enrolled as the observation group, and 167 TBI patients receiving traditional management from January, 2018 to December, 2022 were retrospectively selected as the control group. The primary outcomes were 1-year post-injury Glasgow Outcome Scale (GOS) and Disability Rating Scale (DRS) scores. Secondary outcomes included the incidence of in-hospital complications and the mean indwelling time of tracheal intubation, gastric tube and urinary catheter.

Results The 1-year GOS score was significantly higher (t = -7.836, P < 0.001), and the DRS score was significantly lower (t = -6.742, P < 0.001) in the observation group than in the control group. The overall incidence of complications was significantly lower in the observation group than in the control group (χ² =18.762, P < 0.001). The incidences of pulmonary infection, urinary tract infection, pressure ulcer, lower extremity venous thrombosis and joint contracture deformity were all significantly reduced (χ² >4.328, P < 0.05). The indwelling time of tracheal intubation, gastric tube and urinary catheter was significantly shorter in the observation group than in the control group (t > 10.276, P< 0.001).

Conclusion The acute-critical-comprehensive three-stage standardized TBI rehabilitation unit could significantly improve the long-term functional outcomes of TBI patients, reduce the incidence of complications, and shorten the indwelling time of invasive tubes through multidisciplinary collaboration, whole-course standardized management and information-based quality control. This model conforms to the pathological and functional laws of TBI, realizes seamless whole-course connection from acute treatment to recovery rehabilitation, and has good clinical feasibility and promotion value. It can provide evidence-based evidence and practical reference for the homogenized and standardized development of TBI rehabilitation in China.

Key words: traumatic brain injury, rehabilitation, multidisciplinary team, prognosis

CLC Number:

R651.1

Chi Qianqian, Zhang Xiaonian, Zhu Xiaomin, Sun Wanyue, Zhang Xin, Zhou Jin, Bu Hongwei, Zhai Lei, Zhang Xin, Ling Zirui, Chen Hongyu. Effect of standardized rehabilitation unit on traumatic brain injury[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(9): 1033-1040.

Figures/Tables 5

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References 44

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基线指标	对照组(n = 167)	观察组(n = 324)	t/χ²值	P值
年龄/岁	40.8±18.7	44.2±18.5	-1.992	0.052
性别(男/女)/n	102/65	198/126	0.001	0.975
入院GCS评分	10.5(8.0, 13.0)	10.0(7.5, 12.5)	-0.864	0.388
基础疾病(有)/n	53	101	0.015	0.903
高血压/n	32	60	0.032	0.858
糖尿病/n	15	29	0.001	0.975
冠心病/n	8	16	0.002	0.964
损伤类型(脑挫裂伤)/n	98	190	0.001	0.975
受伤原因(交通事故)/n	105	202	0.028	0.867
伤后昏迷(有)/n	123	237	0.035	0.852

GOS	对照组(n = 167)	观察组(n = 324)	t/χ²值	P值
GOS评分	3.58±0.80	4.12±0.76	-7.836	< 0.001
恢复良好(Ⅴ级)/n	26	86	8.924	0.003
中度残疾(Ⅳ级)/n	52	118	1.628	0.202
重度残疾(Ⅲ级)/n	82	105	14.536	< 0.001
植物生存(Ⅱ级)/n	7	15	0.068	0.794

DRS	对照组(n = 167)	观察组(n = 324)	t/χ²值	P值
DRS评分	11.56±6.81	8.23±5.94	-6.742	< 0.001
无残疾(0~4 分)/n	31	95	9.247	0.002
轻度残疾(5~10分)/n	48	127	8.351	0.004
中度残疾(11~20分)/n	65	88	9.563	0.002
重度残疾(21~30分)/n	23	14	17.285	< 0.001

并发症	对照组(n = 167)	观察组(n = 324)	χ²值	P值
并发症	78	95	18.762	< 0.001
肺部感染	35	42	6.583	0.010
尿路感染	28	31	7.245	0.007
下肢静脉血栓	16	18	4.328	0.038
压疮	12	10	6.015	0.014
关节挛缩畸形	9	6	5.871	0.015

保留管路时间	对照组(n = 167)	观察组(n = 324)	t值	P值
气管插管保留时间	7.8±3.2	4.5±2.1	11.643	< 0.001
胃管保留时间	12.5±4.6	8.3±3.5	10.276	< 0.001
尿管保留时间	9.6±3.8	5.7±2.6	11.038	< 0.001

Effect of standardized rehabilitation unit on traumatic brain injury

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