中国康复理论与实践
中國康複理論與實踐
중국강복이론여실천
CHINESE JOURNAL OF REHABILITATION THEORY & PRACTICE
2015年
8期
960-966
,共7页
李咏雪%顾海风%张涛%陈少贞
李詠雪%顧海風%張濤%陳少貞
리영설%고해풍%장도%진소정
听失认%听理解障碍%失语症%心理语言评定%纯词聋%皮质聋
聽失認%聽理解障礙%失語癥%心理語言評定%純詞聾%皮質聾
은실인%은리해장애%실어증%심리어언평정%순사롱%피질롱
auditory agnosia%auditory comprehension%aphasia%psycholinguistic assessment%pure word deafness%cortical deafness
目的：应用汉语失语症心理语言评定系统明确听失认患者的诊断，探讨其语言加工损害水平，并预测其语言功能的预后。方法对1例左侧颞岛顶叶、右侧颞岛叶、双侧基底节脑梗死所致的听理解严重障碍的患者，采用汉语失语症语言评定系统在发病后4周进行首次语言评定，并对其进行语言训练，发病后8周、3个月再次进行评定，分析其语言加工损害机制及预后。结果患者发病4周后，听觉词-图匹配和视觉词-图匹配正确率分别为2.5%和95.0%(P<0.001)；听觉语义知识和视觉语义知识正确率为5.6%和80.6%(P<0.001)；进一步的听觉输入通路相关检查发现得分均很低，包括声母韵母声调听辨别、最小差异单字听判断、环境声音识别；看图命名正确率67.5%，词复述0，词朗读70.0%，听写0，直接抄写100.0%；发病8周和3个月后语言评定显示，视觉词-图匹配(均100%)、视觉语义知识(97.2%、100%)完全恢复；看图命名(87.5%、90%)、词朗读(87.5%、97.5%)、看图书写(77.5%、87.5%)和抄写(均100%)有所改善；而听觉词-图匹配(5.0%、7.5%)、听觉语义知识(2.8%、5.6%)、复述(0、3.3%)和听写(均为0)未见改变。结论该例以听理解障碍(尤其是听觉语音识别缺陷)为主要语言障碍的患者诊断为听失认。通过3次评定可预测其语言功能的预后，提高这种特殊类型语言障碍患者治疗的针对性。
目的：應用漢語失語癥心理語言評定繫統明確聽失認患者的診斷，探討其語言加工損害水平，併預測其語言功能的預後。方法對1例左側顳島頂葉、右側顳島葉、雙側基底節腦梗死所緻的聽理解嚴重障礙的患者，採用漢語失語癥語言評定繫統在髮病後4週進行首次語言評定，併對其進行語言訓練，髮病後8週、3箇月再次進行評定，分析其語言加工損害機製及預後。結果患者髮病4週後，聽覺詞-圖匹配和視覺詞-圖匹配正確率分彆為2.5%和95.0%(P<0.001)；聽覺語義知識和視覺語義知識正確率為5.6%和80.6%(P<0.001)；進一步的聽覺輸入通路相關檢查髮現得分均很低，包括聲母韻母聲調聽辨彆、最小差異單字聽判斷、環境聲音識彆；看圖命名正確率67.5%，詞複述0，詞朗讀70.0%，聽寫0，直接抄寫100.0%；髮病8週和3箇月後語言評定顯示，視覺詞-圖匹配(均100%)、視覺語義知識(97.2%、100%)完全恢複；看圖命名(87.5%、90%)、詞朗讀(87.5%、97.5%)、看圖書寫(77.5%、87.5%)和抄寫(均100%)有所改善；而聽覺詞-圖匹配(5.0%、7.5%)、聽覺語義知識(2.8%、5.6%)、複述(0、3.3%)和聽寫(均為0)未見改變。結論該例以聽理解障礙(尤其是聽覺語音識彆缺陷)為主要語言障礙的患者診斷為聽失認。通過3次評定可預測其語言功能的預後，提高這種特殊類型語言障礙患者治療的針對性。
목적：응용한어실어증심리어언평정계통명학은실인환자적진단，탐토기어언가공손해수평，병예측기어언공능적예후。방법대1례좌측섭도정협、우측섭도협、쌍측기저절뇌경사소치적은리해엄중장애적환자，채용한어실어증어언평정계통재발병후4주진행수차어언평정，병대기진행어언훈련，발병후8주、3개월재차진행평정，분석기어언가공손해궤제급예후。결과환자발병4주후，은각사-도필배화시각사-도필배정학솔분별위2.5%화95.0%(P<0.001)；은각어의지식화시각어의지식정학솔위5.6%화80.6%(P<0.001)；진일보적은각수입통로상관검사발현득분균흔저，포괄성모운모성조은변별、최소차이단자은판단、배경성음식별；간도명명정학솔67.5%，사복술0，사랑독70.0%，은사0，직접초사100.0%；발병8주화3개월후어언평정현시，시각사-도필배(균100%)、시각어의지식(97.2%、100%)완전회복；간도명명(87.5%、90%)、사랑독(87.5%、97.5%)、간도서사(77.5%、87.5%)화초사(균100%)유소개선；이은각사-도필배(5.0%、7.5%)、은각어의지식(2.8%、5.6%)、복술(0、3.3%)화은사(균위0)미견개변。결론해례이은리해장애(우기시은각어음식별결함)위주요어언장애적환자진단위은실인。통과3차평정가예측기어언공능적예후，제고저충특수류형어언장애환자치료적침대성。
Objective To evaluate the damaged level of auditory processing and diagnose the type of language impairment in an audito-ry agnosia patient using Psycholinguistic Assessment in Chinese Aphasia (PACA), and predict the outcome of the language function. Meth-ods A patient with a bilateral damage involving the temporal lobe could physically hear the sounds, but was unable to recognize or differenti-ate between the sounds. Speech and language evaluations were taken with PACA 4 weeks, 8 weeks and 3 months after the onset of disease. Results At 4 weeks, the correct rates were 2.5%and 95.0%in spoken word-picture matching and written word-picture matching (P<0.001), and were 5.6%and 80.6%in spoken semantic knowledge and written semantic knowledge (P<0.001). The scores of auditory input process-ing function score were low, including phoneme discrimination, spoken word matching with minimal differences, environmental sounds identification. The correct rates were 67.5%in oral picture naming, 0 in word repetition, 70.0%in word reading, 0 in dictation, 100.0%in di-rectly copy writing. At 8 weeks and 3 months, there was complete recovery in written word-picture matching (both 100%) and written se-mantic knowledge (97.2%, 100%), and improvement in oral picture naming (87.5%, 90%), word repetition (87.5%, 97.5%), picture name writing (77.5%, 87.5%) and copy writing (both 100%) (P<0.05). But no change was found in auditory input processing function examina-tions, spoken word-picture matching (5.0%, 7.5%), spoken semantic knowledge (2.8%, 5.6%), word repetition (0, 3.3%) and dictation (both 0). Conclusion The patient was diagnosed as auditory agnosia with the inability to distinguish sounds. PACA can well identify the impaired level of auditory comprehension disorder and the outcome of language function recovery for aphasics.
