基于环境重置的视听觉刺激在脑卒中偏侧忽略的护理研究  

Research of Visual and Auditory Stimulation Based on Environment Reset on Hemi-spatial Neglect in Patients with Cerebral Apoplexy

作　　者：韩宇花 陶希[1] 邓景贵[1] 刘佳[1] 宋涛[1] 何娟[1] 

机构地区：[1]湖南省马王堆医院康复医学科,湖南省脑血管病康复治疗中心,长沙410016

出　　处：《解放军医药杂志》2014年第6期110-113,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

摘　　要：目的探讨基于环境重置的视听觉刺激对脑卒中偏侧忽略(hemispatial neglect,HSN)的影响。方法2010年3月—2012年9月收治的脑卒中HSN 49例随机分为观察组27例和对照组22例。两组均给予常规治疗,对照组对病房及康复环境不做要求,观察组对病房床位及康复环境进行重新设置。于治疗前、治疗4周及治疗8周时分别行直线二等分(LB)测试和线段划消(LC)测试评估HSN的程度,以美国国立研究院脑卒中评定量表(NIHSS)评定神经功能缺损和改良Barthel Index(MBI)评估日常生活活动能力(ADL)。结果治疗4、8周时两组LB、LC及NIHSS评分均低于治疗前,MBI评分均高于治疗前(P<0.05)。治疗8周时两组LB、NIHSS评分和观察组LC均较治疗4周时降低,MBI评分较治疗4周时升高,观察组LB、LC低于对照组,MBI评分高于对照组(P<0.05)。结论基于环境重置的视听觉刺激对脑卒中HSN患者有益,可提高ADL能力,但对神经功能缺损影响可能不大。Objective To explore the effect of visual and auditory stimulation based on environment reset on hemi-spatial neglect（ HSN） in patients with cerebral apoplexy. Methods A total of 49 patients with cerebral apoplexy combined with HSN during March 2010 and September 2012 were randomly divided into control group（ n = 22） and observation group（ n = 27）. Conventional therapy was performed in the two groups. Wards and rehabilitation environment for patients in control group had no special requirement,while wards and rehabilitation environment for patients were reseted regularly. HSN degrees were assessed by test of line bisection（ LB） and line cancellation（ LC）; scores of neurologic impairment were evaluated with National Institute of Health stroke scale（ NIHSS）,and abilities of activity of daily living（ ADL） were evaluated with modified Barthel index（ MBI） before treatment,after treatment for 4 weeks and 8 weeks.Results Compared with those before treatment,scores of LB,LC and NIHSS were significantly decreased,while scores of MBI were significantly increased in both groups after treatment for 4 weeks and 8 weeks（ P〈0. 05）. Compared with those after treatment for 4 weeks,scores of LB and NIHSS in both groups and LC in observation group were significantly reduced,while MBI scores were significantly increased,and in observation group scores of LB and LC were significantly reduced and MBI scores were significantly higher compared with those in control group after treatment for 8 weeks（ P〈 0. 05）. Conclusion Visual and auditory stimulation based on environment reset for hemi-spatial neglect are beneficial to patients with cerebral apoplexy,and can improve the ADL ability,but with little effect to the neurologic impairment.

关 键 词：环境设计 卒中 偏侧忽略 神经功能缺损 日常生活活动能力 

分 类 号：R473.74[医药卫生—护理学]