不同脑半球损伤患者认知功能障碍的比较

A comparison of cognitive dysfunction of patients with different brain hemisphere injuries

目的探讨左、右大脑半球损伤患者在认知功能障碍方面的特点。方法用失语症筛查表、洛文斯顿作业疗法用认知评定成套测验 (LOTCA)对 5 5例左脑损伤患者和 43例右脑损伤患者的认知功能进行评定。结果右脑损伤患者组在地点定向、重叠图形识别、空间知觉、运用能力等方面的成绩明显高于左脑损伤患者组 (P <0 0 0 1— 0 0 0 5 ) ,而在形状视认、视运动组织等方面的成绩则明显低于左脑损伤患者组 (P <0 0 0 1— 0 0 2 ) ;右脑损伤后出现时间定向障碍、形状失认、图形背景分辨障碍、单侧忽略、注意力障碍的可能性明显多于左侧脑损伤 (P <0 0 0 5— 0 0 2 5 ) ,而出现失语、意念运动性失用的可能性明显少于左侧脑损伤 (P <0 0 0 5— 0 0 1) ;左右脑损伤后出现地点定向障碍、物体失认、颜色失认、空间失认、运用失用、结构性失用、思维障碍等方面的可能性无明显差异 (P >0 0 5 )。

ObjectiveTo study possible differences in cognitive dysfunction between left hemisphere injury(LHI) patients and right hemisphere injury(RHI) ones.MethodsCognitive function of 55 LHI patients and 43 RHI patients were examined by aphasia screening test and the Loewenstein Occupational Therapy Cognitive Assessment Battery(LOTCA).ResultsThe scores of RHI group were significant higher than that of LHI group in orientation in place,overlapping figures,spacial perception,praxis( P<0.001-0.005),but significant lower than that of LHI group in visual identification of shapes and visuomotor organization( P<0.001-0.02).The possibilities of RHI group were significant more than that of LHI group in disorientation in time,shape agnosia,disorder in figure-ground identification,unilateral neglect,disordered attention( P<0.005-0.025),but significant fewer than that of LHI group in aphasia,ideomotor apraxia( P<0.005-0.01).The possibilities were no significant differences in disorientation in place,objects agnosia,colour agnosia,spacial agnosia,motor apraxia,constructional apraxia,thinking disorder between RHI group and LHI group( P>0.05).Conclusions There is characteristic cognitive dysfunction after right or left hemisphere injury.