TOMATIS对脑卒中患者急性应激障碍的干预效果研究

APPLICATION OF TOMATIS IN ACUTE STROKE PATIENTS

目的对脑卒中患者实施托马提斯(TOMATIS)听觉-运动训练,探讨TOMATIS听觉-运动训练在脑卒中患者急性应激障碍中的应用效果。方法选取某三甲医院神经内科治疗的159例脑卒中急性应激障碍(ASD)患者,并将其随机分为三组,每组53例;对照组常规干预,音乐组在常规干预的基础上进行音乐训练,听觉训练组进行经处理的高低频转换的听觉-运动训练,连续干预28 d;采用斯坦福急性应激反应问卷,比较干预前后急性应激障碍水平的差异。结果干预后,三组患者在警觉、分离、社会功能损害、SASRQ总分差值方面差异均有统计学意义(均P<0.05)。音乐组警觉及SASRQ总分较干预前降低,应激症状减轻(P<0.05);其警觉差值明显高于对照组(P<0.05)。听觉-运动训练组在警觉、分离、社会功能损害、SASRQ总分方面较干预前降低(P<0.05),应激症状减轻;在警觉方面差值高于对照组,分离、社会功能损害、SASRQ总分差值高于音乐组及对照组。结论TOMATIS听觉-运动训练可减弱或消除脑卒中患者的急性应激障碍症状,缩短患者预后时间,为临床脑卒中患者的康复提供更为便捷的治疗手段。

Objective To explore the application effect of TOMATIS auditory-motor training in stroke patients,and the application effect of TOMATIS auditory-motor training in acute stress disorder of stroke patients.Methods A total of one hundred and fifty-nine patients with ischemic stroke ASD were selected and randomly divided into three groups,53 cases in each group.The control group received routine intervention,the music group received music training on the basis of routine intervention,and the hearing training group received hearing exercise training with high-low frequency conversion,with continuous intervention of 28 d.The Stanford Acute Stress Reaction Questionnaire(SASRQ)was used to compare the differences in the levels of acute stress disorder.Results After intervention,there were significant differences in vigilance,separation,social function impairment and SASRQ total score among the three groups(P<0.05).The total scores of alertness and SASRQ in music group were lower than those before intervention,and the stress symptoms were alleviated(P<0.05);the difference of alertness in music group was significantly higher than that in control group(P<0.05).Compared with the control group,the difference of auditory motor training group in alertness,separation,social function impairment and SASRQ total score was lower(P<0.05),and the stress symptoms were alleviated;in alertness,the difference was higher,in separation,social function impairment and SASRQ total score difference was higher than the music group and the control group.Conclusion TOMATIS hearing-exercise training can reduce or eliminate the symptoms of acute stress disorder in patients with stroke,shorten the prognosis time of patients,and provide a more convenient treatment for the rehabilitation of clinical stroke patients.