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功能独立测量的临床运用分析 |
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刘 鹏 黄东锋
摘要 目的：通过分析功能独立测量（FIM）在临床运用的情况，探讨其作为康复科常规残疾测量的价值。 方法：用FIM对157例康复科住院患者进行测量，并对不同病种入出院FIM值进行配对分析，计算康复效益。 结果：脑卒中、脊髓损伤、脑外伤及其他疾病患者的FIM运动分、认知分及总分均有明显改变（P<0.01）；颈椎病、腰腿痛患者运动分有改变（P<0.01），其康复效益较高；周围神经损伤患者出入院FIM运动分、认知分、总分均无明显变化(P>0.05)，其康复效益低。结论：FIM能反应康复过程中患者功能独立情况的变化，且与不同病种的功能独立情况相符合，可作为康复科常规测量方法。
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(P<0.01). Discharge FIM motor subscale, cognitive subscale and total scor es in patients with peripheral nerve injury hadno change compared with their a dmission FIM (P>0.05). 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。
1 资料和方法
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