视觉刺激训练在脑卒中后重度认知障碍患者中的应用研究  

Application of visual stimulation training in patients with severe cognitive impairment after stroke

作　　者：张倩 孙洁 刘婷慧[1] 高盼盼 Zhang Qian;Sun Jie;Liu Tinghui(The Second Clinical Medical School of Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学第二临床医学院,江苏徐州221000 [2]徐州医科大学医学技术学院,江苏徐州221000 [3]徐州市中心医院,江苏徐州221000

出　　处：《中国康复》2024年第11期655-659,共5页Chinese Journal of Rehabilitation

基　　金：徐州市医学领军人才培养项目(XWRCHT20210024);江苏省老年健康科研项目(LKM2022046);徐州市重点专项(XWKYHT20230012)。

摘　　要：目的:探讨视觉刺激训练在脑卒中后重度认知障碍患者中的应用研究。方法:选取脑卒中后重度认知障碍患者60例,随机分为对照组和研究组各30例。2组均采取药物治疗、常规康复训练。在此基础上,研究组增加为期4周的视觉刺激训练。干预前后,对2组采用简易精神量表(MMSE)评估认知功能,视觉感知能力测试3(TVPS-3)和视知觉感知分测验(VPT)评估视觉和感知觉能力,改良Barthel指数(MBI)评价日常生活能力(ADL)。结果:治疗4周后,2组MMSE、VPT、MBI评分、TVPS-3总分及7个感知领域评分较治疗前提高(P<0.01),研究组MMSE、VPT、MBI、TVPS-3总分及7个感知领域评分均高于对照组(P<0.01),研究组MMSE与VPT评分呈正相关(rs=0.76,P<0.01)。结论:视觉刺激训练能有效提高脑卒中后重度认知障碍患者的认知功能、视知觉感知能力和日常生活能力,且视知觉感知能力与认知功能存在显著正相关关系。Objective:To explore the application of visual stimulation training in patients with severe cognitive impairment after stroke.Methods:Totally,60patients with severe post-stroke cognitive impairment were randomly divided into 30cases in the control group and 30cases in the study group,and both groups were treated with medication and conventional rehabilitation training.The patients in the study group were given 4weeks of visual stimulation training,additionally.Before and after the intervention,cognitive function was assessed by the MMSE,visual perceptual ability was assessed by the test of visual perception 3(TVPS-3)and the visual perception subtest(VPT),and the ability to perform activities of daily living was assessed by the modified Barthel index(MBI)in the control and study groups.Results:After 4weeks of treatment,MMSE,VPT,the 7domains of TVPS-3and MBI scores in the 2groups were increased as compared with the pre-treatment scores(P<0.01),and MMSE,VPT,MBI,the scores of DIS,MEM and SEQ in theTVPS-3of the study group were higher than those of the control group(P<0.05,0.01),and there was a positive correlation between the MMSE and VPT scores of the study group(rs=0.76,P<0.01).Conclusion:Visual stimulation training can effectively improve the cognitive function,visual perception ability and activities of daily living of patients with severe cognitive impairment after stroke,and there was a significantly positive correlation between visual perception ability and cognitive function.

关 键 词：脑卒中 视觉刺激训练 重度认知障碍 视知觉感知能力 日常生活能力 

分 类 号：R49[医药卫生—康复医学] R741[医药卫生—临床医学]