重度脑外伤恢复期患者认知障碍的临床特点及其影响因素

Characteristics and Related Factors of Cognitive Impairment for Severe Traumatic Brain Injury

目的了解重度脑外伤患者认知障碍的特点,分析相关影响因素。方法 2015年9月至2017年9月,对94例重度脑外伤恢复期患者采用蒙特利尔认知评估量表(MoCA)进行评定,记录病史资料。结果脑外伤患者延迟回忆、抽象、语言、视空间与执行、注意评分较低,命名、记忆、定向、计算评分较高。额叶损伤患者MoCA总分、注意、抽象和延迟回忆评分低于基底节损伤;额颞顶叶损伤患者总分、命名、抽象和延迟回忆评分低于基底节损伤。多元回归分析显示,受伤后昏迷时间、损伤部位对患者MoCA总分存在明显影响(P <0.05),发病年龄、性别、病程、损伤侧与患者无明显相关性(P> 0.05)。结论脑外伤恢复期患者存在多方面认知功能损伤,认知障碍与昏迷时间和损伤部位相关。

Objective To investigate the characteristics of cognitive impairment of patients with severe traumatic brain injury(TBI)and to analyze the related factors.Method From September,2015 to September,2017,94 patients surviving from severe TBI were assessed with Montreal Cognitive Assessment(MoCA),and their baseline data were recorded in detail.Results The scores were lower in the recall,abstraction,verbal fluency,visual executive and attention of MoCA,and higher in naming,digit span,orientation and calculation.The scores in total,attention,abstraction and recall were lower in patients with frontal lobe injury than those with basal ganglion injury.The scores in total,naming,abstraction and recall were lower in patients with frontal-temporal-parietal lobes injury than those with basal ganglion injury.Multivariate regression showed that the time of coma and the location of injury were the related factors to the total score of MoCA(P<0.05).Conclusion Cognitive impairment after TBI demostrates commonly in many aspects,which are related with the time of coma and the area of injury.