手势引导对言语失用伴口颜面失用的临床疗效观察  

Observation on Clinical Efficacy of Hand Gesture Guidance Applied to Apraxia of Speech and Buccofacial Apraxia

作　　者：陆云[1] 雷斌[1,2] 冉军 刘丽君 LU Yun;LEI Bin;RAN Jun;LIU Li-Jun

机构地区：[1]同济大学附属养志康复医院,上海201619 [2]无锡国济康复医院,无锡214000

出　　处：《中国听力语言康复科学杂志》2020年第1期57-61,共5页Chinese Scientific Journal of Hearing and Speech Rehabilitation

基　　金：上海市残疾人联合会科研入围项目(K2014030)。

摘　　要：目的探索手势引导对言语失用伴口颜面失用导致的运动性言语障碍的临床疗效。方法选取2014年2月~2019年6月上海市养志康复医院神经康复科收治的脑卒中后存在重度言语失用伴口颜面失用患者30例,采用随机数字法分为试验组和对照组,2组患者均给予常规康复治疗,试验组在此基础上辅以手势引导。治疗前后分别采用中国康复研究中心版言语失用(修改后)、口颜面失用评估量表及汉语拼音音节表评价患者言语功能改善情况。结果治疗前两组患者言语失用、口颜面失用、音节表评分组间差异均无统计学意义(P>0.05)。治疗后两组患者各项评分均较治疗前显著提高,且治疗后试验组患者的改善幅度较显著,与对照组间差异均具有统计学义(P<0.05)。试验组吹气、单音节单次复述、单音节多次复述、多音节多次复述评分显著优于对照组(P<0.05)。结论手势引导结合构音运动学及速度节律控制法能有效改善脑卒中患者言语失用、口颜面失用,显著提高患者口语表达功能,该联合疗法值得临床推广、应用。Objective To explore the clinical efficacy of hand gesture guidance on motor speech disorder caused by apraxia of speech and buccofacial apraxia.Method Thirty patients with severe apraxia of speech and buccofacial apraxia after stroke admitted to the Department of Neurology of Shanghai Yangzhi Rehabilitation Hospital from February 2014 to July 2019 were randomly divided into an experimental group and a control group.The both groups were given routine rehabilitation treatment,and the experimental group was supported by hand gesture guidance.The speech function improvement was assessed by speech apraxia and buccofacial apraxia assessment method of Chine Rehabilitation Research Center Edition(revised)and by Chinese Pinyin syllable table respectively before and after the treatment.Results There was no significant difference in apraxia of speech,buccofacial apraxia and syllable score between the two groups before treatment(P>0.05).After treatment,there was considerable improvement on each section of the two groups,and the improvement of the experimental group was sizable after treatment,and the difference between the two groups was statistically significant(P<0.05).Breathing-single repetitions of monosyllabic words-multiple repetitions of monosyllabic words-manifold repetitions of polysyllabic words in the experimental group were significantly better than those in the control group(P<0.05).Conclusion Gesture guidance combined with articulatory–kinematic and rate/rhythm approaches can effectively improve apraxia of speech and apraxia of facial in stroke patients,and significantly improve oral expression function of patients.The combined therapy is worth clinical promotion and application.

关 键 词：手势引导 言语失用 口颜面失用 运动性言语障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]