Bell K R, Tallman C A
University of Washington, Department of Rehabilitation Medicine, Seattle 98195, USA.
Brain Inj. 1995 Apr;9(3):315-20. doi: 10.3109/02699059509008201.
Although evidence exists for delayed recovery after traumatic brain injury, patients who do not receive rehabilitation early after their injuries often remain permanently in long-term care facilities. Case reports of five severely brain-injured persons who were discharged into long-term nursing care facilities for at least 1 year before initial rehabilitation admission are discussed. After prescreening for evidence of functional improvement, these patients were admitted to a rehabilitation unit with the goal of community discharge. Functional improvement was evaluated using the Functional Independence Measure (FIM) and additional categories of function. Community discharge was successfully achieved in all five patients, who demonstrated particular improvement in bathing, transfers, memory, bowel management, problem solving and independence during waking hours. Further efforts should be made to identify patients in long-term care facilities who might benefit from rehabilitation services, and to identify those factors which contribute to successful community discharge.
尽管有证据表明创伤性脑损伤后恢复会延迟，但受伤后未早期接受康复治疗的患者往往会长期留在长期护理机构。本文讨论了5例重度脑损伤患者的病例报告，这些患者在首次康复入院前已被安置在长期护理机构至少1年。在预先筛查功能改善的证据后，这些患者被收治到康复单元，目标是出院后回归社区。使用功能独立性测量量表（FIM）和其他功能类别对功能改善情况进行评估。所有5例患者均成功实现了回归社区，他们在洗澡、转移、记忆、肠道管理、问题解决以及清醒时的独立性方面有显著改善。应进一步努力识别长期护理机构中可能从康复服务中受益的患者，并确定那些有助于成功回归社区的因素。
