单侧空间忽略的检测方法研究

Study of the assessment methods for unilateral spatial neglect

目的探讨8种国内、外较常用的单侧空间忽略检测方法的敏感性及影响因素。方法应用删除试验、数字消去法、平分直线法、画钟试验、自由画图、字体试验、临摹画图、目测黑点数等8种单侧空间忽略检测方法对400名正常人进行量化评定,同时对随机选择的33例脑卒中患者进行临床检测。结果正常人字体试验和目测黑点数的检测结果全部正常,其它方法的检测结果均有不同程度的异常。自由画图、画钟试验、平分直线法和临摹画图的异常率随被检者年龄的增长、文化程度的降低而增高。临床应用中,数字消去法、目测黑点数和字体试验检出率较低,分别为71.43%、57.13%和42.86%,其他方法检出率均为100%。结论不同的检测方法的敏感性和影响因素不同,单纯采用一种检测方法不能明确被检者是否存在单侧空间忽略,多种方法同时应用可提高检出率。

Objective To compare the sensitivity of 8 assessment methods of unilateral spatial neglect and explore their respective influence factors. Methods Four hundred normal subjects and 33 stroke patients were assessed with the 8 methods, namely the cross-out test, digit cancellation test, line bisection, clock drawing, free hand drawing, Chinese character test, drawing copy, visual numeration of smudge. Results In normal subjects, various degrees of abnormalities were detected with 6 methods except the Chinese character style test and smudge numeration test. And there was a close relationship between the increase in abnormality ratio of free-hand drawing, clock-drawing, line bisection test and drawing copy and the old age and lower level of education. In the stroke patients, digit cancellation test, smudge numeration test and character test had a low diagnosis ratio. The others had high diagnosis ratio. Conclusion One method does not diagnose USN because of various influence factors and sensitivity. We should apply different methods to increase clinical detection ratio of USN.