配偶参与式注意力训练与言语听觉反馈训练用于急性脑卒中病人认知功能康复的临床研究

A clinical study of spouse participatory attention training and speech auditory feedback training in cognitive rehabilitation of acute cerebral apoplexy patients

目的:评价配偶参与式注意力及言语听觉反馈训练对脑卒中病人认知功能康复的临床效果。方法:选择90例缺血性脑卒中合并认知功能障碍的病人为研究对象,随机分为观察组(n=48)与对照组(n=42)。对照组给予常规康复方案,观察组给予配偶参与式注意力训练与言语听觉反馈训练,评价2组病人干预前后蒙特利尔认知评估量表(MoCA)评分与症状自评量表SCL-90评分。结果:出院后3个月复测,观察组与对照组MoCA中位值分别为23.0(17.0,25.0)与19.5(16.0,23.0),观察组高于对照组(P<0.05~P<0.01)。观察组与对照组干预后焦虑、抑郁、躯体化、强迫症状及人际关系敏感性评分与对照组差异均有统计学意义,观察组干预后上述维度评分下降更为明显(P<0.05~P<0.01)。结论:配偶参与式注意力、言语听觉反馈训练方案可显著促进脑卒中病人认知功能康复,改善神经心理症状,具有较高的应用价值。

Objective:To evaluate the clinical effects of spouse participatory attention training and speech auditory feedback training in cognitive rehabilitation of patients with stroke.Methods:Ninety patients with ischemic stroke complicated with cognitive dysfunction were randomly divided into the observation group(n=48)and control group(n=42).The control group was trained using conventional rehabilitation program,and the observation group was trained using the spouse participatory attention training and speech auditory feedback training.The Montreal cognitive assessment(MoCA)score and SCL-90 score in two groups were evaluated before and after intervention.Results:The median of MoCA in observation group(23.0)was higher than that in control group(19.5)after 3 months of discharge(P<0.05 to P<0.01).The differences of the anxiety,depression,somatization,obsessive-compulsive symptoms and interpersonal relationship sensitivity scores after intervention between two groups were statistically significant,and the scores of the above dimensions decreased more obviously in the observation group after intervention(P<0.05 to P<0.01).Conclusions:The spouse participatory attention training and speech auditory feedback training can significantly promote the cognitive function rehabilitation and improve neuropsychological symptoms in patients with stroke.It has high application value.