功能独立测量的临床运用分析.docVIP

功能独立测量的临床运用分析 关键词　医疗康复；功能测量；残疾 A clinical analysis of Functional Independent Measurement LIU Peng, HUANG Dongfeng Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University of Medical Sciences, Guangzhou , 510080 Abstract Objective:To investigate the value offunctional independent me asurement(FIM) on routine clinical impairment. Method:FIM were used tomeasure 157 patients. Admission and discharge FIM scores of patients with rel ated diseases, such as stroke, spinal cordinjury,etc,were analyzed by paired sa mples t test.Result:Discharge FIM motor subscale, cognitive subscale and total scores in patients of stroke, spinal cord injury, traumatic brain injury and other diseases patients were higher thantheir admission FIM, while in cervical spondylopathy and lumbocrural pain patients′ FIM motor subscale sco re(P0.01). Discharge FIM motor subscale, cognitive subscale and total scor es in patients with peripheral nerve injury hadno change compared with their a dmission FIM (P0.05). Conclusion:FIM may reflect thechange of functional independence in patients during their rehabilitation process, whi ch conforms to various related functions.FIM may be used as a conventional meas urement in department of rehabilitation. Key words　Medical rehabilitation; Functional measure;Disability 　　功能独立测量(Functional Independent Measure, FIM)是美国医学康复统一数据库 ( Uniform Data System for Medical Rehabilitation,UDSMR)的重要组成部分，经过广泛的临床验证，其信度和效度已得到确认〔1〕，国内亦有人作过其信度与效度的研究〔2，3〕，但国内有关FIM临床使用情况尚报道较少。现将我院康复科近两年应用FIM的资料进行分析，探讨FIM作为医疗康复过程中残疾测量常规方法的价值。 成都耳鼻喉医院 1　资料和方法 1.1　一般资料 　　观察对象均系1996年1月至1998年2月间我院康复科的住院患者，共157例。其中男性99例，女性58例；年龄12岁～84岁，平均49.4±16.7岁；诊断：脑卒中59例、脊髓损伤22例、脑外伤12例（以上均经CT或MRI确诊）、颈椎病及腰腿痛40例、周围神经损伤8例、其它疾病16例（包括骨折、脑脓肿、血管性头痛、断肢再植术后等）；住院时间6～80天，平均28.85天。 1.2 　方法 　　应用功能独立检查表（FIM），该表由我科编译，测量参照美国UDSMR 4.0版本及缪鸿石等编译本〔4〕。FIM功能独立分级标准为：108～126分为独立，54～107分为部分依赖（其中54～71分为重度依赖，72～89分为中度依赖，90～107分为轻度依赖），18～53分为完全依赖。测量人员经培训后，对所有患者在入院后及出院前72小时 内测FIM。 1.3　资料统计 　　应用SPSS6.0软