早期强化认知功能训练对脑卒中患者神经功能及日常生活能力的影响  

Effect of early intensive cognitive training on the neurological function and activities of daily living in patients with cerebral stroke

作　　者：王丽英[1] 张琰[1] 王静[1] 祁亚琼 白晓艳[1] 朱海霞[1] WANG Li-ying;ZHANG Yan;WANG Jing;QI Ya-qiong;BAI Xiao-yan;ZHU Hai-xia(Department of Rehabilitation,the Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,Inner Mongolia,China)

机构地区：[1]内蒙古医科大学附属医院康复科

出　　处：《生物医学工程与临床》2019年第4期433-437,共5页Biomedical Engineering and Clinical Medicine

基　　金：内蒙古医科大学科研基金项目

摘　　要：目的探讨早期强化认知功能训练结合系统性康复治疗对脑卒中(CS)患者神经功能和日常生活能力(ADL)的影响。方法选取124例经影像学确诊的CS患者,其中男性67例,女性57例;年龄36~74岁,平均年龄62.17岁。随机分为接受系统性康复治疗的对照组和给予早期强化认知功能训练治疗的联合组。联合组62例,其中男性33例,女性29例,平均年龄62.04岁。对照组62例,其中男性34例,女性28例,平均年龄61.83岁。比较两组治疗前后神经功能缺损量表(NDS)评分、采用改良的Barthel指数(MBI)进行日常生活能力(ADL)评分、Loewenstein认知功能评定量表(LOTCA)评价认知功能变化、简式Fugl-Meyer运动功能评分评价运动功能。并记录脑血流动力学参数。结果治疗前,两组NDS、MBI、LOTCA、FMA评分及脑血流动力学参数比较,差异均无统计学意义(P>0.05);治疗后,两组NDS评分均显著降低[联合组治疗前后(26.72±7.13)分vs(11.53±3.34)分,对照组治疗前后(26.29±7.08)分vs(19.07±6.11)分](P<0.05),MBI[联合组治疗前后(30.65±8.82)分vs(63.85±9.21)分,对照组治疗前后(31.04±8.86)分vs(47.36±8.93)分]、LOTCA[联合组治疗前后(46.15±8.57)分vs(69.40±9.33)分,对照组治疗前后(46.48±8.60)分vs(60.53±8.95)分]、FMA[联合组治疗前后(21.10±5.34)分vs(56.18±10.36)分,对照组治疗前后(21.69±5.38)分vs(44.73±8.25)分]评分均显著升高(P<0.05),且与对照组比较,联合组NDS、MBI、LOTCA、FMA评分变化幅度更大(P<0.05)。治疗后,两组脉搏波速(Wv)差异均无统计学意义(P>0.05),颈动脉最小血流速度(Vmin)、最小血流量(Qmin)、动态阻抗(DR)均显著升高(P<0.05),脑血管外周阻力(R)、临界压力(CP)均显著降低(P<0.05),且联合组上述脑血流动力学参数降低或升高幅度大于对照组(P<0.05)。结论早期强化认知功能训练结合系统性康复治疗可有效改善CS患者预后,改善患者神经功能、认知功能、运动功能,提高ADL和减轻�Objective To investigate the effect of early intensive cognitive training combined with systematic rehabilitation therapy on the neurological function and activities of daily living(ADL) in patients with cerebral stroke(CS).Methods A total of 124 CS patients who diagnosed by imaging were enrolled,which included 67 males and 57 females,aged 36 - 74 years old with mean age of 62.17 years old.All of them were randomly divided into control group(performed with systemic rehabilitation therapy,n = 62,included 34 males and 28 females,mean age of 61.83 years old) and combined group(additionally given early intensive cognitive training,n = 62,included 33 males and 29 females,mean age of 62.04 years old).The neurological defect scale(NDS) before and after treatment between 2 groups were compared.The modified Barthel index(MBI) was used for ADL score,and Loewenstein cognitive function rating scale(LOTCA) was used to evaluate change of cognitive function.Simple Fugl- Meyer motor function score was used to evaluate motor function,and cerebral hemodynamic parameters of 2 groups were recorded.Results Before treatment,there was no significant difference in scores of NDS,MBI,Loewenstein occupational therapy cognition assessment(LOTCA),simple Fugl-Meyer motor function assessment(FMA) and cerebral hemodynamic parameters between 2 groups(P > 0.05).After treatment,NDS scores were significantly decreased[combined group was (26.72 ± 7.13, before) vs (11.53 ± 3.34,after),and control group was (26.29 ± 7.08,before) vs (19.07 ± 6.11,after)](P < 0.05).The scores of MBI [combined group was (30.65 ± 8.82,before) vs (63.85 ± 9.21,after),control group was (31.04 ± 8.86,before) vs (47.36 ± 8.93, after),LOTCA[combined group was (46.15 ± 8.57,before) vs (69.40 ± 9.33,after),control group was (46.48 ± 8.60,before) vs (60.53 ± 8.95,after)] and FMA[combined group was (21.10 ± 5.34,before) vs (56.18 ± 10.36,after),control group (21.69 ± 5.38,before) vs (44.73 ± 8.25,after)] of 2 groups were significantly increased.Compared with contro

关 键 词：卒中 认知功能训练 康复治疗 神经功能 日常生活能力 

分 类 号：R743.3[医药卫生—神经病学与精神病学]