37例老年脑卒中认知功能障碍康复治疗研究

Study on the cognitive dysfunction rehabilitation therapy in 37 elderly patients with stroke

目的:探讨认知康复对老年脑卒中认知功能和日常生活能力的影响,为早期认知康复治疗提供临床依据。方法:选择住院脑卒中患者37例,随机分为认知康复组(研究组19例)和对照组(18例)。研究组:益智治疗(双益平)+认知康复治疗;对照组:益智治疗(双益平)。所有患者均接受脑血管病常规治疗+运动康复治疗,疗程8周。采用简易精神状态量表(Mini-Mental State Examination,MMSE)评定认知功能,Barthel指数评定日常生活活动能力(activities of daily life,ADL)。分析认知康复对脑卒中患者认知功能及ADL的影响。结果:研究组与对照组治疗前后MMSE分值比较差异显著,P<0.001;研究组治疗后定向、记忆、注意力、计算力、回忆和语言能力各认知项目均有提高,P均<0.05;与对照组比较在定向、注意力、计算力和回忆能力提高明显,P均<0.05,而记忆、语言能力与对照组比较无统计学意义;研究组与对照组治疗前后Barthel指数比较差异显著,P<0.001,研究组生活活动能力改善。结论:认知康复能有效改善老年脑卒中患者的认知功能和日常生活活动能力,早期介入认知康复对患者功能状态的良好转轨非常重要。

ABSTRACT Objective： To discuss the impact of cognitive rehabilitation on the cognitive function and activities of daily life （ADL） of elderly patients with stroke. Methods： Thirty seven hospitalized patients were randomly divided into either a study group （19 patients） or a control group （18 patients）. The study group was treated with Yizhi （dual benefits Ping plus cognitive rehabilitation while the control group was treated only with Yizhi. Meanwhile, all patients received a conventional treatment including cerebral vascular and sports rehabilitation for 8 weeks. The cognitive function and ADL were evaluated by Mini-Mental State Examination （MMSE） and Barthel index, respectively. Results： The between-group difference was significant in MMSE scores before and after treatment （P〈0.001）. The orientation, memory, attention, calculation and language ability of patients in the study group have been enhanced （P〈0.05）, and all the indications mentioned above accept for recollection and language ability in the control group have been improved （/〈0.05）. The between-group difference before and after treatment is significant in the Barthel index （P〈0.001）. Conclusion： Cognitive rehabilitation can effectively improve the cognitive function and ADL of elderly patients with stroke. Early intervention of cognitive rehabilitation is very important on functional status in patients with good prognosis. KEY WORDS elderly stroke; cognitive rehabilitation; activities of daily life