作业疗法对急性脑梗死患者认知功能及事件相关电位的影响  

Effects of occupational therapy on the cognitive function and event-related potentials of patients with acute cerebral infraction

作　　者：徐从英[1] 张晓玲[1] 吴华[1] 官俏兵[1] 朱敏初[1] 王琰萍[1] 

机构地区：[1]浙江省嘉兴市第二医院神经内科,嘉兴314000

出　　处：《中华物理医学与康复杂志》2014年第11期847-850,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的 观察作业疗法对急性脑梗死患者认知功能及其事件相关电位（ERP） P300的影响.方法 根据简易精神状况量表（MMSE）评分选取98例伴有认知功能障碍的急性脑梗死患者,采用随机数字表法将其分为观察组（49例）及对照组（49例）.2组患者均给予常规康复训练,观察组患者在此基础上辅以作业治疗.于治疗前、治疗8周后分别采用洛文斯顿作业疗法认知评定量表（LOTCA）、改良Barthel指数（MBI）对2组患者认知功能及日常生活活动（ADL）能力进行评定,同时对2组患者事件相关电位（P300）进行检测.结果 入选时2组患者LOTCA评分、MBI评分、P300潜伏期及波幅等指标组间差异均无统计学意义（P＞0.05）;治疗8周后发现2组患者上述指标均较治疗前有一定程度改善,并以观察组患者LOTCA评分[（99.4±8.4）分]、MBI评分[（80.7±5.9）分]、P300潜伏期[（373.45±52.13） ms]及波幅[（7.87土2.63）μV]的改善幅度较显著,与治疗前及对照组间差异均具有统计学意义（P＜0.05）.结论 在常规康复训练基础上辅以作业治疗,可进一步提高脑梗死后认知功能障碍患者ADL能力,改善其认知功能,该联合疗法值得临床推广、应用.Objective To explore the effect of occupational therapy on the cognitive function and P300 event-related potentials （ERPs） of patients with acute cerebral infraction.Methods Ninety-eight acute cerebral infarction patients with cognitive impairment were selected using the mini-mental state examination （MMSE）.They were randomly divided into an observation group （n =49） who received occupational therapy plus routine rehabilitation treatment and a control group （n =49） who received only the routine rehabilitation treatment.Before and after 8 weeks of treatment,the patients＇ cognitive function and their ability in the activities of daily living（ADL） were evaluated using the Loewenstein Occupational Therapy Cognitive Assessment （LOTCA） and the modified Barthel index （MBI）,respectively.P300 ERPs were also detected.Results There was no significant difference between the two groups with regard to various scores before the treatment （P ＞ 0.05）.After 8 weeks of treatment,the LOTCA and MBI scores and the latency and amplitude of ERPs were significantly better than those before treatment in both groups （P ＜ 0.05）.In the observation group,the scores of LOTCA （99.4 ± 8.4）,MBI （80.7 ± 5.9） and the latency and amplitude of ERPs [（373.45 ± 52.13） ms and （5.87 ± 2.63） μV,respectively] were significantly better than those in the control group（P ＜ 0.05）.Conclusion Occupational therapy program based on conventional rehabilitation training can promote the ADL ability and cognitive function of patients with acute cerebral infraction.It is worth applying in clinical practice.

关 键 词：作业疗法 脑梗死 认知功能障碍 事件相关电位 

分 类 号：R743.33[医药卫生—神经病学与精神病学]