基于危险因素构建的Forbrain认知训练干预处方对脑外伤认知功能障碍患者的影响  

Effect of Forbrain Cognitive Training Intervention Prescriptions Based on Risk Factors on Patients with Cognitive Impairment After Traumatic Brain Injury

作　　者：张雪茹 王鸿滨 崔慧英 郝习君 陈长香 ZHANG Xueru;WANG Hongbin;CUI Huiying;HAO Xijun;CHEN Changxiang(School of Nursing and Rehabilitation,North China University of Science and Technology,Tangshan,Hebei 063210,China)

机构地区：[1]华北理工大学护理与康复学院,河北唐山063210

出　　处：《康复学报》2023年第4期310-316,共7页Rehabilitation Medicine

基　　金：河北省重点研发计划项目(21377748D)。

摘　　要：目的:观察基于危险因素构建的Forbrain认知训练干预处方对脑外伤患者认知功能及日常生活能力的影响。方法:选择2021年10月—2022年5月在唐山市工人医院治疗的脑外伤(TBI)认知功能障碍患者120例,采用Excel随机函数分为对照组、观察1组与观察2组,每组40例。干预过程中,对照组、观察1组与观察2组分别脱落或中止3、1、1例,最后3组分别纳入37、39、39例。对照组接受神经外科常规护理措施;观察1组在常规护理基础上给予Forbrain认知训练(鼓励患者进行阅读训练);观察2组在常规护理基础上接受基于脑外伤认知功能障碍危险因素(失眠、头痛、抑郁、低社会支持和上肢运动功能障碍)构建的Forbrain认知训练干预方案。以上干预均20 min/次,2次/d,共干预2周。于干预前后采用洛文斯顿作业认知评定量表(LOTCA-Ⅱ)评价患者认知功能;采用Barthel指数量表(BI)评价患者日常生活活动能力。结果:①认知功能:与干预前比较,观察1组和观察2组干预后LOTCA-Ⅱ总分均更高,差异具有统计学意义(P<0.05);与对照组比较,观察1组干预后动作运用及专注力评分均明显更高,观察2组干预后视知觉评分、动作运用评分、视运动组织时间评分、思维操作评分、专注力评分和LOTCA-Ⅱ总分均明显更高,差异具有统计学意义(P<0.05)。与观察1组比较,观察2组干预后视知觉评分、LOTCA-Ⅱ总分均明显更高,差异具有统计学意义(P<0.05)。②日常生活活动能力:与干预前比较,观察1组和观察2组干预后BI评分均明显更高,差异具有统计学意义(P<0.05)。与对照组、观察1组比较,观察2组干预后BI评分明显更高,差异具有统计学意义(P<0.05)。结论:基于危险因素构建的Forbrain认知训练干预方案可提高TBI患者认知功能和日常生活活动能力,值得临床推广。Objective:To observe the effect of Forbrain cognitive training intervention prescriptions based on risk factors on cognitive function and activities of daily living in patients with cognitive impairment after traumatic brain injury(TBI).Methods:A total of 120 patients with cognitive impairment after TBI treated in Tangshan Workers'Hospital from October 2021 to May 2022 were randomly divided into control group,observation group 1 and observation group 2 according to Excel random function,with 40 cases in each group.During the intervention,3,1,1 cases dropped out respectively in the control group,observation group 1 and observation group 2,and 37,39 and 39 cases were finally included in the three groups respectively.The control group received neurosurgical routine nursing care;the observation group 1 received Forbrain cognitive training(reading training was encouraged)in addition to the routine care;the observation group 2 received the Forbrain cognitive training intervention prescriptions based on the risk factors of cognitive dysfunction(insomnia,headache,depression,low social support and upper limb motor dysfunction)in addition to the routine care.For all of the three groups,the interventions were provided for 20 minutes a time,twice a day,lasting for two weeks.Before and after intervention,the Loeweistein Occupational Therapy Cognitive Assessment(LOTCA)-Ⅱwas used to evaluate the patients'cognitive function;Barthel Index(BI)was used to evaluate the activities of daily living ability of patients.Results:(1)Cognitive function:compared with that before treatment,the total score of LOTCA-Ⅱin the observation group 1 and the observation group 2 were higher after intervention,and the differences were statistically significant(P<0.05);compared with the control group,the scores of praxis and attention in the observation group 1 after intervention were significantly higher,and the scores of visual perception,action application score,visual movement organization time score,operation of thinking score,concentration scor

关 键 词：脑外伤 认知功能障碍 Forbrain认知训练 危险因素干预 日常生活活动能力 

分 类 号：R473.74[医药卫生—护理学]