Valpar系统联合计算机辅助技术治疗早期血管性认知障碍的疗效观察

Valpar technology can improve the treatment of early vascular cognitive impairment

目的观察Valpar系统联合计算机辅助技术治疗早期血管性认知障碍（VCI）的疗效。方法选取40例符合人选标准的早期VCI患者，按照随机数字表法将其分为治疗组和对照组，每组20例。2组患者均给予常规认知康复训练和计算机辅助治疗，治疗组在此基础上采用Valpar系统进行认知功能训练。治疗前、治疗4周后及8周后，采用洛文斯顿作业疗法认知功能评定量表（LOTCA）和改良Barthel指数（MBI）对2组患者进行认知功能和ADL能力评定。结果治疗前，2组患者LOTCA评分和MBI评分之间比较，差异无统计学意义（P〉0．05）。治疗组治疗4周后及8周后，LOTCA各项评分、LOTCA总分及MBI评分均较治疗前改善（P〈0．05）。对照组治疗4周后，定向能力[（3．50±0．89）分]、视知觉[（13．50±1．43）分]、空间知觉[（2．40±0．50）分]、视运动组织[（24．00±1．17）分]及注意力评分[（2．30±0．87）分]较治疗前明显改善（P〈0．05），治疗8周后LOTCA各项评分、LOTCA总分及MBI评分均较治疗前改善（P〈0．05）。与对照组治疗后同时间点比较，治疗组治疗4周后及8周后LOTCA各项评分、LOTCA总分、MBI评分均较为优异（P〈0．05）。结论Valpar系统联合计算机辅助技术能显著改善早期VCI患者的认知功能和ADL能力，值得临床应用、推广。

Objective To observe the therapeutic effect of the Valpar system combined with computer-aided technology in treating early vascular cognitive impairment （ VCI）. Methods Forty patients in the early stage of VCI were randomly divided into a treatment group and a control group, each of 20. Regular and computer-aided cognition training were applied in both groups, while training using the Valpar system was additionally used in the treatment group. Patients in both groups were assessed using the Loewenstein Occupational Therapy Cognitive Assessment （LOTCA） and the modified Barthel Index （MBI） before, and after 4 and 8 weeks of treatment. Results Before the treatment, there were no significant differences between the 2 groups in LOTCA and MBI scores （P〉0.05）. After 4 and 8 weeks of treatment, the average total LOTCA score in the observation group was significantly better than before the treatment, as were the average scores on the various dimensions, and the average MBI score （P〈0.05）. After 4 weeks of treatment the control group showed significant improvement in the patients＇ orientation （3.50±0.89）, visual perception （ 13.50± 1.43 ） , spatial perception （ 2.40± 0.50） , visuomotor construction （ 24.00± 1.17） and attention （2.30±0.87）. However, after both 4 and 8 weeks of treatment, all the measurements of the observation group were significantly better than those of the control group at the same time point （P〈0.05）. Conclusion The Valpar system can significantly improve the recovery of cognitive function and ability in the activities of daily living of patients in the early stage of VCI. It is worth applying in clinical practice.