计算机辅助训练结合高压氧治疗脑卒中患者认知障碍的疗效分析

Efficacy of Computer aided Training combined with Hyperbaric Oxygen Therapy on Stroke Patients with Cognitive Dysfunction

目的：探讨计算机辅助训练结合高压氧治疗脑卒中认知障碍患者的临床疗效。方法：60例脑卒中认知障碍患者随机分为对照组、高压氧组和联合治疗组各20例，3组均接受基础药物治疗和常规康复治疗，高压氧组增加高压氧治疗，联合治疗组增加计算机辅助认知训练和高压氧治疗。治疗前和治疗4周后分别进行蒙特利尔认知量表（MoCA）、简式Fugl-Meyer运动量表（FMA）和Barthel指数（BI）评定。结果：治疗后高压氧组和联合治疗组MoCA、FMA和BI评分均明显高于对照组（〈0.05），其中联合治疗组MoCA和BI评分较高压氧组有明显改善（〈0.05），但FMA评分2组间差异无统计学意义。MoCA评分各分项得分与FMA、BI得分相关性分析结果显示，FMA得分与视空间与执行能力（VS-EF）、记忆（MEM）、注意（ATT）、抽象概括（ABS）、延迟记忆（D-MEM）显著相关（=0.324~0.521，〈0.05或0.01），BI得分与VS-EF、命名（NAM）、MEM、ATT、ABS、D-MEM、定向力（ORI）显著相关（=0.342~0.537，〈0.05或0.01）。结论：计算机辅助认知训练结合高压氧治疗可有效改善脑卒中患者认知功能。

Objective：To explore the clinical effects of computer aided training combined with hyperbaric oxygen therapy （HBOT） on stroke patients with cognitive dysfunction. Methods： Sixty stroke patients with cognitive dysfunction were randomly assigned to groups of control, HBOT and combined treatment, with 20 cases in each group. The 3 groups were treated with basic medication and traditional rehabilitation therapy while HBOT group was treated additionally with HBOT and combined treatment group was treated additionally with HBOT and computer aided training. Montreal Cognitive Assessment（MoCA）, Fugl-meyer Scale（FMA） and Barthel Index（BI） were assessed at pre-therapy and 4 weeks after treatment. Results：The scores of MoCA, FMA and BI in HBOT group and combined treatment group after treatment were much higher than those of control group （ 〈0.05）, while the scores of MoCA and BI in combined treatment group demonstrated much higher than those of HBOT group （ 〈0.05）. However, there was no significant difference of FMA scores between 2 groups after treatment. The correlation between sub-items of MoCA and FMA, BI were analyzed. There were significant correlations between FMA scores and five sub-items（VS-EF, MEM, ATT, ABS, D-MEM ） scores of MoCA （ =0.324~0.521, 〈0.05 or 0.01）. Significant correlations between BI scores and seven sub-items （VS-EF, NAM, MEM, ATT, ABS, D-MEM, ORI） scores of MoCA （=0.342~0.537, 〈0.05 or 0.01） were also shown. Conclusion： Computer aided training combined with HBOT can effectively improve cognitive function of stroke patients.