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病因及临床特征对小儿重度获得性脑损伤康复进程及功能恢复的影响

The effect of etiological and clinical characteristics on the rehabilitation process and functional gains in pediatric severe acquired brain injury.

作者信息

Aras Berke, Çulha Canan, Varol Alp, Yaşar Evren

机构信息

Department of Physical Medicine and Rehabilitation, Health Sciences University, Gülhane Faculty of Medicine, Ankara Bilkent City Hospital, Ankara, Türkiye.

Yozgat Bozok University Rector, Yozgat, Türkiye.

出版信息

Turk J Phys Med Rehabil. 2024 Jul 26;71(1):74-82. doi: 10.5606/tftrd.2024.14479. eCollection 2025 Mar.

Abstract

OBJECTIVES

The aim of this study was to investigate the etiological and clinical characteristics of pediatric patients with severe acquired brain injury and their effects on rehabilitation outcomes.

PATIENTS AND METHODS

A total of 67 pediatric patients (39 males, 28 females; mean age: 9.7±4.8 years; range, 3 to 18 years) who were hospitalized due to severe acquired brain injury between March 2020 and October 2021 were retrospectively analyzed. The patients were classified in five different groups according to the etiology: traumatic brain injury, anoxic brain injury (ABI), cerebrovascular accident, encephalitis, and brain tumors. The time of brain injury, etiology, length of stay in the intensive care unit, additional injuries, presence of operation, nutritional status, history of tracheotomy, duration of rehabilitation and complications were recorded. The factors affecting the difference between the Functional Ambulation Classification (FAC) scores of the patients before and after rehabilitation were evaluated.

RESULTS

The mean time since injury was 83.04±57.29 days and the mean duration of rehabilitation was 55.37±37.15 days. Statistically significant improvements were found in all the groups in the functional levels and FAC scores after rehabilitation. In the inter-group comparisons, the ABI group showed statistically less improvement than the other groups. The functional level of the patients before rehabilitation, etiology and the presence of fecal incontinence were statistically significant factors that affected the change in FAC scores (p=0.043, p=0.049, p=0.048, and p=0.035, respectively).

CONCLUSION

Our study results show that rehabilitation yields in positive outcomes even in patients with severely acquired brain injury in the pediatric age group.

摘要

目的

本研究旨在调查重度获得性脑损伤儿科患者的病因和临床特征及其对康复结局的影响。

患者与方法

回顾性分析了2020年3月至2021年10月期间因重度获得性脑损伤住院的67例儿科患者(男39例,女28例;平均年龄:9.7±4.8岁;范围3至18岁)。根据病因将患者分为五个不同组:创伤性脑损伤、缺氧性脑损伤(ABI)、脑血管意外、脑炎和脑肿瘤。记录脑损伤时间、病因、重症监护病房住院时间、其他损伤、手术情况、营养状况、气管切开史、康复时间和并发症。评估影响患者康复前后功能步行分类(FAC)评分差异的因素。

结果

受伤后的平均时间为83.04±57.29天,平均康复时间为55.37±37.15天。康复后所有组的功能水平和FAC评分均有统计学意义的改善。组间比较中,ABI组的改善在统计学上低于其他组。康复前患者的功能水平、病因和大便失禁情况是影响FAC评分变化的统计学显著因素(分别为p = 0.043、p = 0.049、p = 0.048和p = 0.035)。

结论

我们的研究结果表明,即使是儿科年龄组的重度获得性脑损伤患者,康复也能产生积极的结果。

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Plasticity in the injured brain: more than molecules matter.损伤脑内的可塑性:不仅仅是分子 Matters.
Neuroscientist. 2014 Feb;20(1):15-28. doi: 10.1177/1073858413491146. Epub 2013 Jun 11.

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