基于颅脑外伤患者认知障碍特点的临床治疗对策  

Clinical treatment based on features of cognitive impairment in patients with traumatic brain injury

作　　者：欧海荣[1] 梁仔 李越[1] 覃木秀[1] Ou Hairong;Liang Zai;Li Yue;Qin Muxiu(Unit One of Department of Neurosurgery,Wuchuan People’s Hospital,Zhanjiang 524500,China;Stroke Center,Lianjiang Affiliated Hospital of Guangdong Medical University,Zhanjiang 524400,China)

机构地区：[1]广东省吴川市人民医院神经外科一区,湛江524500 [2]广东医科大学附属廉江医院脑卒中科,湛江524400

出　　处：《中华脑科疾病与康复杂志（电子版）》2019年第5期293-296,共4页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

摘　　要：目的基于颅脑外伤患者认知障碍(CI)的临床对策初探。方法选择吴川市人民医院脑外科及广东医科大学附属廉江医院脑卒中科自2017年1月至2018年1月收治的60例颅脑外伤后CI患者作为研究对象,所有患者接受颅脑外伤综合治疗(常规治疗+高压氧治疗+脑康复治疗),记录患者各项临床资料(基本资料、类型、诊断),对患者治疗前后认知功能[洛文斯顿认知功能量表(LOT-CA)]进行评估和分析治疗后认知功能的改善情况。结果60例颅脑外伤患者的CI表现:9例(15%)为逻辑推理力降低,19例(32%)为记忆功能减退,8例(13%)为注意力不集,8例(13%)为感知感觉力下降,16例(27%)为语言功能下降。双侧半球损伤、右侧半球损伤、左侧半球损伤后CI患者经治疗后LOT-CA评分均高于入院时评分,差异有统计学意义(P<0.05)。结论颅脑外伤综合治疗对不同类型和损伤部位颅脑外伤后CI患者的疗效确切,临床工作中应重视并积极治疗颅脑外伤后患者的认知功能,以改善患者的预后。Objective To explore the clinical strategy of cognitive impairment(CI)in patients with traumatic brain injury.Methods Sixty cases of CI patients after traumatic brain injury,admitted to neurosurgery department of Wuchuan People’s Hospital and Stroke Center of Lianjiang Affiliated Hospital of Guangdong Medical University,were collected from January 2017 to January 2018.All the patients with traumatic brain injury were given comprehensive treatment(conventional therapy+hyperbaric oxygen therapy+brain rehabilitation treatment),and record the patients clinical data,type,diagnosis(basic data),as well as evaluate cognitive function score[Loewenstein occupational therapy cognitive assessment(LOT-CA)]before and after treatment,and analysis of the improvement of cognitive function in patients after treatment.Results The CI of 60 patients with traumatic brain injury was reduced by 9 cases(15%),19 cases(32%),8 cases(13%),8 cases(13%),8 cases(13%),and 16 cases(27%).After treatment,the LOT-CA score of CI patients with bilateral hemisphere injury,right hemisphere injury and left hemisphere injury was all higher than the score on admission,with statistically significant differences(P<0.05).Conclusion The comprehensive treatment of traumatic brain injury has an effective effect on patients with CI after traumatic brain injury of different types and injury sites.It is necessary to pay attention to and actively treat the cognitive function of patients after traumatic brain injury in clinical work to improve the prognosis of patients.

关 键 词：颅脑外伤 认知障碍 综合治疗 

分 类 号：R651.15[医药卫生—外科学] R749.12[医药卫生—临床医学]