CAJ | 학술논문

目的：探讨基于环境重置的视听觉刺激对脑卒中偏侧忽略( hemispatial neglect, HSN)的影响。方法2010年3月-2012年9月收治的脑卒中HSN 49例随机分为观察组27例和对照组22例。两组均给予常规治疗,对照组对病房及康复环境不做要求,观察组对病房床位及康复环境进行重新设置。于治疗前、治疗4周及治疗8周时分别行直线二等分( LB)测试和线段划消( LC)测试评估HSN的程度,以美国国立研究院脑卒中评定量表( NIHSS)评定神经功能缺损和改良Barthel Index( MBI)评估日常生活活动能力( ADL)。结果治疗4、8周时两组LB、LC及NIHSS评分均低于治疗前,MBI评分均高于治疗前(P<0．05)。治疗8周时两组LB、NIHSS评分和观察组LC均较治疗4周时降低,MBI评分较治疗4周时升高,观察组LB、LC低于对照组,MBI评分高于对照组(P<0．05)。结论基于环境重置的视听觉刺激对脑卒中HSN患者有益,可提高ADL能力,但对神经功能缺损影响可能不大。
목적：탐토기우배경중치적시은각자격대뇌졸중편측홀략( hemispatial neglect, HSN)적영향。방법2010년3월-2012년9월수치적뇌졸중HSN 49례수궤분위관찰조27례화대조조22례。량조균급여상규치료,대조조대병방급강복배경불주요구,관찰조대병방상위급강복배경진행중신설치。우치료전、치료4주급치료8주시분별행직선이등분( LB)측시화선단화소( LC)측시평고HSN적정도,이미국국립연구원뇌졸중평정량표( NIHSS)평정신경공능결손화개량Barthel Index( MBI)평고일상생활활동능력( ADL)。결과치료4、8주시량조LB、LC급NIHSS평분균저우치료전,MBI평분균고우치료전(P<0．05)。치료8주시량조LB、NIHSS평분화관찰조LC균교치료4주시강저,MBI평분교치료4주시승고,관찰조LB、LC저우대조조,MBI평분고우대조조(P<0．05)。결론기우배경중치적시은각자격대뇌졸중HSN환자유익,가제고ADL능력,단대신경공능결손영향가능불대。
Objective To explore the effect of visual and auditory stimulation based on environment reset on he-mi-spatial neglect ( HSN) in patients with cerebral apoplexy. Methods A total of 49 patients with cerebral apoplexy combined with HSN during March 2010 and September 2012 were randomly divided into control group (n=22) and ob-servation group (n=27). Conventional therapy was performed in the two groups. Wards and rehabilitation environment for patients in control group had no special requirement, while wards and rehabilitation environment for patients were rese-ted regularly. HSN degrees were assessed by test of line bisection ( LB) and line cancellation ( LC);scores of neurologic impairment were evaluated with National Institute of Health stroke scale ( NIHSS) , and abilities of activity of daily living ( ADL) were evaluated with modified Barthel index ( MBI) before treatment, after treatment for 4 weeks and 8 weeks. Results Compared with those before treatment, scores of LB, LC and NIHSS were significantly decreased, while scores of MBI were significantly increased in both groups after treatment for 4 weeks and 8 weeks ( P<0. 05 ) . Compared with those after treatment for 4 weeks, scores of LB and NIHSS in both groups and LC in observation group were significantly reduced, while MBI scores were significantly increased, and in observation group scores of LB and LC were significantly reduced and MBI scores were significantly higher compared with those in control group after treatment for 8 weeks ( P<0. 05 ) . Conclusion Visual and auditory stimulation based on environment reset for hemi-spatial neglect are beneficial to patients with cerebral apoplexy, and can improve the ADL ability, but with little effect to the neurologic impairment.