[Traumatic brain injury: psychological sequelae are often underestimated]

Effect of integrated perioperative rehabilitation intervention under the fast-track surgery concept on stress and complications in patients undergoing craniocerebral injury surgery

Objective

To observe the intervention effect of perioperative rehabilitation intervention of integrated medical care the concept of FTS on stress response and postoperative complications in patients undergoing craniocerebral injury surgery.

Methods

70 patients with Traumatic brain injury (TBI) admitted to the Department of Neurosurgery of our Hospital from January 2019 to December 2021 were as the research objects and were divided into general group and FTS group according to the random number table method, with 35 cases in each group. The general group was intervened with perioperative basic nursing measures for TBI, and the FTS group was intervened with perioperative rehabilitation model of integrated medical care under the concept of FTS on the basis of the general group. The two groups of patients were compared in hemodynamic indexes (heart rate, mean arterial pressure), stress hormone levels (CORT, GLU, E), changes in motor neurological function (GCS score, NHISS score, FMA score), occurrence of postoperative complications (infection, pressure sores, rebleeding, central hyperthermia), short-term quality of life (SF-36) before and after the intervention.

Results

After intervention, the levels of HR, MAP, COR, GLU, and E were significantly lower in FTS group than in the general group (all P < 0.05). After intervention, the Fugl-Meyer score and Barthel index score of upper and lower extremities in both groups were significantly higher than those before intervention, and the FTS group was higher than the general group, and the difference was statistically significant (P < 0.05). After the intervention, the NIHSS scores were significantly lower in both groups than before the intervention, and the FTS group was lower than the general group, and the differences were statistically significant (P < 0.05). Short-term physical function, somatic pain, physical function, general health status, social function, energy, mental health, and emotional function scores were significantly higher in the FTS group than in thegeneral group, and all differences were statistically significant (P < 0.05). The total incidence of infection, pressure ulcers, rebleeding, central high fever and other complications in the FTS group was significantly lower than that in the general group (P < 0.05).

Conclusion

The implementation of integrated perioperative rehabilitation interventions under the concept of FTS for patients with TBI can significantly alleviate patients' stress, promote recovery, reduce the incidence of complications, and improve short-term quality of life, which is worthy of clinical promotion.

Effect of Cognitive Behavioral Therapy on Stress Disorder, Cognitive Function, Motor Function, and Daily Living Ability of Patients with a Traumatic Brain Injury

Purpose

The aim of the study is to observe the effects of cognitive behavioral therapy on stress disorder, cognitive function, motor function, and daily living ability of traumatic brain injury (TBI) patients.

Methods

84 patients with TBI admitted to our hospital from June 2019 to May 2021 were selected as the research subjects. They were divided into a control group (from June 2019 to May 2020) and an observation group (from June 2020 to May 2021), with 42 cases in each group. The control group received routine intervention; the observation group received cognitive behavioral therapy on the basis of the control group. Before and after intervention, the posttraumatic stress disorder (PTSD), cognitive function, motor function, and daily living ability of the two groups were observed.

Results

After intervention, the PTSD-self-rating scale (PTSD-SS) scores of both groups were lower than those before intervention, and the PTSD-SS scores of the observation group were lower than those of the control group (P < 0.05). After intervention, the scores of the Montreal cognitive assessment (MoCA) scale, Fugl-Meyer assessment (FMA), and modified Barthel index (MBI) in both groups were higher than those before intervention, and the scores of MoCA, FMA, and MBI in the observation group were higher than those in the control group (P < 0.05).

Conclusion

The application of cognitive behavioral therapy to TBI patients is beneficial to reduce the degree of PTSD and improve cognitive function, motor function, and daily living ability, which is worthy of clinical application.

[Features of the patient management with traumatic brain injury]

The aim of our study was to consider features of pathogenesis, diagnosis and therapy of traumatic brain injury (TBI) from the viewpoint of neurologist. The mechanisms of emerging injury of the central nervous system, including neuro-inflammation and oxidative stress in patients with TBI, and correlations between clinical manifestations and severity of TBI are discussed. Special attention is paid to the description of certain TBI consequences, e.g. structural drug-resistant epilepsy and post-traumatic stress disorder. We provide evidence for difficulties and lesser availability of rehabilitation programs to patients with TBI during COVID-19 pandemics. One should mention a need for administration of Mexidol as the antioxidant/antihypoxant drug into complex therapy of TBI in such patients. In the period of COVID-19 pandemics, the role of neurologist in management of TBI patients still increases, especially, at the outpatient treatment stage, and when carrying out therapy and medical rehabilitation programs.