不同部位损伤对颅脑外伤病人认知功能的影响

Effects of different parts injury on cognitive function in patients with craniocerebral trauma

目的分析不同部位损伤对颅脑外伤病人认知功能的影响,以期为病人的早期诊治提供切实可靠的临床依据。方法对海南医学院第二附属医院神经外科收治的292例颅脑外伤病人,应用蒙特利尔认知评估量表(MoCA)进行认知功能评估,对不同损伤部位病人的认知功能进行对比、分析。结果 292例病人中认知功能障碍总发生率为67.81%,其中不同部位病人认知功能障碍发生率比较差异有统计学意义(P<0.05),以丘脑组发生率最高90.63%,额叶组次之89.19%,而小脑组发生率最低36.67%。不同组别之间MoCA总分、注意与集中、执行功能、语言、记忆等方面比较差异有统计学意义(P<0.05),其中额叶组的执行功能评分显著低于其他组,差异有统计学意义(P<0.05),枕叶组、顶叶组、丘脑组和基底节组显著低于其他组的记忆评分,差异有统计学意义(P<0.05),颞叶组注意与集中评分、语言评分均显著低于其他组,差异有统计学意义(P<0.05)。结论不同部位颅脑损伤对认知功能的损害特点差异明显,MoCA认知功能评定对指导治疗和预后有积极的临床意义。

Objective By analyzing the effect of different parts on the cognitive function of patients with craniocerebral trauma,a reliable clinical basis for the early diagnosis and treatment of patients were provided.Methods 292 patients with craniocerebral trauma admitted to hospital neurosurgery were enrolled in this study.The cognitive function of all patients was assessed by the Montreal Cognitive Assessment Scale(MoCA).The function was compared and analyzed.Results The total incidence of cognitive dysfunction was 67.81%in 292 patients,and the incidence of cognitive dysfunction was significantly different in different parts(P<0.05).The incidence in thalamus was 90.63%,89.19%in the frontal lobe group and 36.67%in the cerebellum group.There were significant differences in the scores of MoCA between different groups(P<0.05),and the executive function scores of the frontal lobe group were significantly lower than those of the other groups,and the differences were statistically significant(P<0.05).The difference between the occipital group,the parietal group,the thalamus group and the basal ganglia group was significantly lower than that of the other groups(P<0.05).The concentration score of the temporal lobe group was significantly lower than that of other groups.The difference was statistically significant(P<0.05).Conclusion It has positive clinical significance for guiding treatment and prognosis to clarify the cognitive impairment characteristics of brain injuries in various parts.