个性化脑认知功能护理与训练在成人烟雾病手术患者中的应用研究  

Application of Personalized Cognitive Function Nursing and Training in Adult Patients with Moyamoya Disease after Surgical Revascularization

作　　者：赵东红[1] 张东[1] 薛锐 袁巧玲[1] ZHAO Dong-Hong;ZHANG Dong;XUE Rui;YUAN Qiao-Ling(Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院神经外科,北京100070

出　　处：《中国卒中杂志》2021年第11期1144-1149,共6页Chinese Journal of Stroke

基　　金：北京市医院管理局“登峰”人才培养计划(DFL20180501)。

摘　　要：目的探讨个性化脑认知功能护理与训练在成人烟雾病脑血运重建手术患者中的应用效果。方法连续前瞻性入组2018年11月-2020年7月首都医科大学附属北京天坛医院行脑血运重建手术治疗的成人烟雾病患者,随机分为对照组和研究组。对照组住院期间给予常规护理;研究组在常规护理的基础上进行个性化脑认知功能护理与训练。比较两组术前和随访3个月时的成人韦氏智力量表(Wechsler adult intelligence scale,WAIS)、中文版剑桥前瞻性记忆测试(Chinese version of the Cambridge prospective memory test,CAMPROMPT)和重复性成套神经心理状态测验(repeatable battery of neuropsychological state,RBANS)中的中的即刻记忆(immediate memory,IM)分项和延迟记忆(delayed memory,DM)分项得分。比较两组术后3个月缺血性和出血性卒中复发率和预后(mRS 0~1分为神经功能正常,2~3分为轻度残疾,4~5分为重度残疾)。结果研究共入组140例患者,对照组和研究组各70例,两组基线资料和术前认知功能评分差异均无统计学意义。3个月随访时,研究组与对照组WAI S差异无统计学意义(98.11±11.16分vs 95.27±14.83分,P=0.202);研究组的CAMPROMPT评分(22.99±4.11分vs 20.41±5.69分,P=0.003)、RBANS-DM(89.86±18.96分vs 79.54±16.12分,P=0.001)、RBANS-IM(84.43±12.35分vs 79.61±15.93分,P=0.048)评分均高于对照组。结论对成人烟雾病脑血运重建手术治疗的患者实施个性化脑认知功能护理与训练,有利于患者认知功能,特别是记忆力的康复。Objective To explore the effect of personalized cognitive function nursing and training in cognitive function recovery of adult patients with Moyamoya disease(MMD)who received surgical revascularization.Methods This study prospectively enrolled the adult MMD patients who underwent surgical revascularization in Beijing Tiantan Hospital between November 2018 and July 2020.All the patients were randomly divided into observation group and control group.The routine care were given in control group;and individualized cognitive function nursing and training based on routine nursing were given in observation group.The cognition scores of preoperative and postoperative 3-months between the two groups were compared,including Adult Webster’s Intelligence Scale(WAIS),the Chinese version of the Cambridge Prospective Memory Test(CAMPROMPT)and the Repeatable Battery of Neuropsychological State(RBANS)[including immediate memory(IM)and delayed memory(DM)].The ischemic and hemorrhagic events and prognosis were compared between the two group during the 3-month follow-up.The prognosis was evaluated by mRS,with a score of 0-1 for normal neurological function,2-3 for mild disability,and 4-5 points for severedisability.Results A total of 140 adult patients with MMD were included,including 70 cases in control group and 70 cases in observation group.There were no statistical differences in baseline data and preoperative cognitive function score between the two groups.No significant difference in WAIS score(observation vs control:98.11±11.16 points vs 95.27±14.83 points)was observed(P>0.05)between the two groups.The scores of CAMPROMPT(22.99±4.11 points vs 20.41±5.69 points,P=0.003),RBANS-DM(89.86±18.96 points vs 79.54±16.12 points,P=0.001)and RBANS-IM(84.43±12.35 points vs 79.61±15.93 points,P=0.048)were higher in observation group than those in control group.Conclusions The application of personalized cognitive function nursing and training in adult MMD patients after surgical revascularization was an important treatment metho

关 键 词：个性化脑认知功能训练 烟雾病 脑血运重建手术 预后 认知功能 记忆力 

分 类 号：R473.6[医药卫生—护理学]