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目的:探讨PET-CT评价结合早期康复对颅脑外伤患者康复治疗疗效及预后的影响。方法:患者随机分为对照组、早期康复组和早期康复+PET-CT评价组,每组各30例;对照组接受外科常规手术及对症支持治疗,早期康复组在外科手术及对症支持治疗基础上进行早期康复治疗,早期康复+PET-CT评价组在进行早期康复治疗前及治疗后3个月进行PET-CT评价。3个月后分别通过格拉斯哥评分、神经功能缺损程度、Fugl-Meyer评分法(FMA)和改良Barthel指数(MBI)等,比较2组患者治疗后功能改善程度。以CT和PET-CT分别预测早期康复组和早期康复+PET-CT评价组中处于植物状态的患者经康复治疗后苏醒的可能性,评价两种预测方法的准确率。结果:早期康复组患者的GSC、神经功能缺损程度、FMA、MBI和并发症发生率与对照组比较有显著性差异(P<0.05);PET-CT可提示颅脑损伤区域的脑功能状态,并可较为准确地预测处于植物状态的患者苏醒可能性。结论:早期康复治疗可以显著改善脑外伤患者的神经功能;PET-CT可以早期发现患者的康复进展,并且对判断病情预后有一定帮助。
OBJECTIVE: To investigate the effect of PET-CT combined with early rehabilitation on rehabilitation and prognosis of patients with craniocerebral trauma. Methods: The patients were randomly divided into control group, early rehabilitation group and early rehabilitation + PET-CT evaluation group, with 30 cases in each group. The control group received conventional surgery and symptomatic supportive therapy. The early rehabilitation group underwent surgery and symptomatic supportive care The patients in the early rehabilitation + PET-CT evaluation group were evaluated by PET-CT before the early rehabilitation and 3 months after the treatment. After 3 months, the degree of functional improvement was compared between the two groups by Glasgow score, degree of neurological deficit, Fugl-Meyer score (FMA) and modified Barthel index (MBI). CT and PET-CT were used to predict the recovery rate of patients in the early rehabilitation group and the early rehabilitation + PET-CT evaluation group after rehabilitation. The accuracy of the two prediction methods was evaluated. Results: The incidences of GSC, neurological deficits, FMA, MBI and complications in early rehabilitation group were significantly different from those in control group (P <0.05). PET-CT was able to indicate brain functional status in brain injury area, And more accurately predict the possibility of recovery in patients in the plant state. Conclusion: Early rehabilitation can significantly improve the neurological function of patients with traumatic brain injury. PET-CT can early detect the recovery of patients and help to determine the prognosis.