中国卫生标准管理
中國衛生標準管理
중국위생표준관리
China Health Standard Management
2015年
24期
46-49
,共4页
管筱玲%岳卫东%姚虹%张晓梅
管篠玲%嶽衛東%姚虹%張曉梅
관소령%악위동%요홍%장효매
不同部位脑梗死%认知功能障碍%神经心理学
不同部位腦梗死%認知功能障礙%神經心理學
불동부위뇌경사%인지공능장애%신경심이학
Different types of cerebral infarction%Cognitive dysfunction%Neuropsychological
目的：应用神经心理学测验研究不同部位脑梗死与认知功能障碍的关系，并摸索不同部位脑梗死致认知功能损害的特点，为有针对性的施行康复训练提供理论参考。方法收集100例初发脑梗死的急性期患者，包括丘脑12例，额叶20例，颞叶16例，基底节37例，脑干15例，运用蒙特利尔认知评估量表（MoCA）、日常生活能力量表（ADL）、缺血指数量表（HIS）对研究对象进行综合认知功能评估，记录各认知域的MoCA分值并评估，确定患者受损的认知功能域。结果丘脑梗死患者在语言、注意力、视空间及执行能力、延迟回忆项目评分均降低，以语言项目降低最明显（P<0.05）。额叶梗死患者在视空间及执行能力、定向力、注意力及延迟回忆项目分值均降低，尤以视空间及执行能力项目降低最为明显（P<0.05）。颞叶梗死患者在命名、延迟回忆、视空间及执行能力、定向力项目分值降低，以命名及延迟回忆项目降低最为明显（P<0.05）。基底节梗死患者在语言、注意力、延迟回忆、定向力、视空间及执行能力项目评分均有所降低，但与其他组比较降低程度没有统计学差异。脑干梗死患者认知功能评分变化无统计学意义。结论脑梗死患者认知障碍的发生与梗死部位有关，且不同部位梗死后认知功能损害的表现有所不同。
目的：應用神經心理學測驗研究不同部位腦梗死與認知功能障礙的關繫，併摸索不同部位腦梗死緻認知功能損害的特點，為有針對性的施行康複訓練提供理論參攷。方法收集100例初髮腦梗死的急性期患者，包括丘腦12例，額葉20例，顳葉16例，基底節37例，腦榦15例，運用矇特利爾認知評估量錶（MoCA）、日常生活能力量錶（ADL）、缺血指數量錶（HIS）對研究對象進行綜閤認知功能評估，記錄各認知域的MoCA分值併評估，確定患者受損的認知功能域。結果丘腦梗死患者在語言、註意力、視空間及執行能力、延遲迴憶項目評分均降低，以語言項目降低最明顯（P<0.05）。額葉梗死患者在視空間及執行能力、定嚮力、註意力及延遲迴憶項目分值均降低，尤以視空間及執行能力項目降低最為明顯（P<0.05）。顳葉梗死患者在命名、延遲迴憶、視空間及執行能力、定嚮力項目分值降低，以命名及延遲迴憶項目降低最為明顯（P<0.05）。基底節梗死患者在語言、註意力、延遲迴憶、定嚮力、視空間及執行能力項目評分均有所降低，但與其他組比較降低程度沒有統計學差異。腦榦梗死患者認知功能評分變化無統計學意義。結論腦梗死患者認知障礙的髮生與梗死部位有關，且不同部位梗死後認知功能損害的錶現有所不同。
목적：응용신경심이학측험연구불동부위뇌경사여인지공능장애적관계，병모색불동부위뇌경사치인지공능손해적특점，위유침대성적시행강복훈련제공이론삼고。방법수집100례초발뇌경사적급성기환자，포괄구뇌12례，액협20례，섭협16례，기저절37례，뇌간15례，운용몽특리이인지평고량표（MoCA）、일상생활능역량표（ADL）、결혈지수량표（HIS）대연구대상진행종합인지공능평고，기록각인지역적MoCA분치병평고，학정환자수손적인지공능역。결과구뇌경사환자재어언、주의력、시공간급집행능력、연지회억항목평분균강저，이어언항목강저최명현（P<0.05）。액협경사환자재시공간급집행능력、정향력、주의력급연지회억항목분치균강저，우이시공간급집행능력항목강저최위명현（P<0.05）。섭협경사환자재명명、연지회억、시공간급집행능력、정향력항목분치강저，이명명급연지회억항목강저최위명현（P<0.05）。기저절경사환자재어언、주의력、연지회억、정향력、시공간급집행능력항목평분균유소강저，단여기타조비교강저정도몰유통계학차이。뇌간경사환자인지공능평분변화무통계학의의。결론뇌경사환자인지장애적발생여경사부위유관，차불동부위경사후인지공능손해적표현유소불동。
Objective The relationship between different types of cerebral infarction and features of cognitive dysfunction was discussed. The study also mentioned the possibility of more accurate rehabilitation training according to the types of cerebral infarction.Methods 100 patients with first-ever cerebral infarction were recruit,including 12 patients with thalamus infarction,20 patients with frontal lobe infarction,16 patients with temporal lobe infarction,37 patients with basal ganglia infarction and 15 patients with brain stem infarction. MoCA,ADL and HIS scale were adapted to evaluate the patients comprehensive cognitive abilities. The domanial cognitive functions evaluated by MoCA were analyzed in detail to ascertain the cognitive dysfunction of different infarction.Results The abilities of language,attention,visual space,execution and delayed recal were damaged in patients with thalamus infarction. The ability of language was lowered the most obviously in this group(P< 0.05). As to the patients with frontal infarction, visual spacial and executive ability,orientation,attention and delayed recal decreased significantly. The decline of visual spacial and executive ability were had statistical difference(P< 0.05). In the temporal group,the scores of naming,delayed recal,visual spacial and executive ability and orientation decreased,naming and delayed recal preceded the others(P< 0.05). The infarction of basal ganglia caused a general decline in the ability of language,attention,delayed recal,orientation,visual spacial and executive functions. But compared to other groups,there was no statistical difference. At last,it seemed that there was no cognitive decrease in the patients with brain stem infarction.Conclusion The presentation of cognitive dysfunction is related to the position of infarction. And the manifestation of cognitive lesion is also corelated to different types of cerebral infarction.
