脑外伤患者损伤部位与语言功能受损的关系

Relationship between injury site and impaired speech function in patients with traumatic brain injury

目的了解脑外伤患者语言功能受损情况,分析损伤部位与语言功能受损的关系,为临床治疗及康复提供参考依据。方法选取797例脑创伤患者为研究对象,于外伤后7~10 d采用蒙特利尔认知评估量表(MoCA)、简易精神状态量表(MMSE)评测其语言功能,通过CT检查确定患者损伤部位。结果脑外伤患者MoCA语言得分为(2.16±1.13)分,语言功能受损者占42.53%;MMSE语言得分为(7.20±2.51)分,语言功能受损者占51.57%;基于MoCA语言评分多元线性回归分析显示,颞叶、额叶、脑干、顶叶及基底节损伤是脑外伤患者语言功能受损的影响因素,P均<0.05。基于MMSE语言评分多元线性回归分析显示,颞叶、额叶、脑干、丘脑损伤是脑外伤患者语言功能受损的影响因素,P均<0.05。两种评测方法结果一致的是颞叶、额叶、脑干预测语言功能,不一致的是MoCA显示顶叶及基底节,MMSE显示丘脑也影响语言功能。结论脑外伤患者语言功能受损率较高,颞叶、额叶、脑干及基底节等部位损伤可预测语言功能受损情况,临床上应着重关注,合理制定诊疗计划。

Objective To understand the language function impairment in patients with brain trauma,and analyze the relationship between the injury site and the language function impairment,so as to provide reference for clinical treatment and rehabilitation.Methods 797 patients with traumatic brain injury were selected.Their language function was evaluated by Montreal Cognitive Assessment Scale(MoCA)and Simplified Mental State Scale(MMSE)7 to 10 days after trauma,and the site of injury was determined by CT examination.Results The MoCA score of TBI patients was(2.16±1.13),and 42.53%of them had impaired language function.MMSE language score was(7.20±2.51),and 51.57%of patients had impaired language function.Multiple linear regression analysis based on MoCA language score showed that temporal lobe,frontal lobe,brainstem,parietal lobe and basal ganglia injury were the influencing factors of language function impairment in TBI patients(P<0.05).Multiple linear regression analysis based on MMSE language score showed that temporal lobe,frontal lobe,brainstem and thalamus injury were the influencing factors of language function impairment in TBI patients(P<0.05).The results of the two evaluation methods were consistent in that temporal lobe,frontal lobe and brainstem predicted language function,but inconsistent in that MoCA showed parietal lobe and basal ganglia,and MMSE showed thalamus also affected language function.Conclusion The rate of impaired language function in patients with brain trauma is high.The damage of temporal lobe,frontal lobe,brainstem and basal ganglia can predict impaired language function.Clinical attention should be paid to the rational diagnosis and treatment plan.