三级语言指令训练方法在老年脑卒中失语症患者康复中的应用

目的探讨三级语言指令训练方法对老年脑卒中失语患者语言功能恢复的效果。方法选择2018年4月-2019年6月复旦大学附属华山医院老年科收治的脑卒中后失语患者100例,采用随机数字表法分为观察组(n=50)和对照组(n=50)。对照组采用常规治疗和常规语言干预的方式,观察组在对照组的基础上,遵循循序渐进的康复理念,进行重点三级语言指令训练。观察并比较2组患者入组时、干预1个月后和3个月后的失语商及生活质量评分(SF-36)变化。结果干预前,2组失语商差异无统计学意义(P>0.05);干预后,2组失语商均高于同组干预前,且观察组失语商明显高于对照组(P<0.05),提示干预后观察组患者的失语改善比对照组患者更显著。干预前,2组SF-36评分差异无统计学意义(P>0.05);干预后,2组SF-36评分均高于同组干预前,且观察组SF-36评分明显高于对照组(P<0.01),提示干预后观察组的生活质量改善比对照组更明显。结论三级语言指令训练方法在老年脑卒中失语患者康复期的应用,遵循循序渐进的康复理念,能有效的促进患者语言功能的康复,有效提高患者的生活质量和患者及家属的满意度。

Application of three-level language instruction training method in rehabilitation of elderly stroke patients with aphasia

Objective To explore the effect of three-level language instruction training method on the recovery of language function in elderly stroke patients with aphasia.Methods 100 patients with aphasia after stroke admitted to Department of Geriatrics,Huashan Hospital Affiliated to Fudan University from April 2018 to June 2019 were randomly divided into observation group(n=50)and control group(n=50).The control group was treated with conventional treatment and language intervention.On the basis of the control group,the observation group were treated with three-level language instruction training based on the concept of gradual rehabilitation.The changes of aphasia quotient and quality of life score(SF-36)were observed and compared between the two groups at the time of admission,1 month after intervention and 3 months after intervention.Results Before the intervention,there was no significant difference in the aphasia quotient between the two groups(P>0.05).After the intervention,the aphasia quotient of the two groups were higher than that of the same group before the intervention,and the aphasia quotient of the observation group was significantly higher than that of the control group(P<0.05),which suggested that the aphasia improvement of the observation group was more significant than that of the control group.Before the intervention,there was no significant difference in SF-36 scores between the two groups(P>0.05).After the intervention,SF-36 scores of the two groups were higher than those of the same group before the intervention,and SF-36 scores of the observation group were significantly higher than those of the control group(P<0.01),which suggested that the improvement of quality of life of the observation group was more obvious than that of the control group.Conclusion Following the concept of gradual rehabilitation,the application of the three-level language instruction training method in the rehabilitation period of elderly stroke patients with aphasia can effectively promote the rehabilitation of the patient’s language function,effectively improve the life quality of patients and the satisfaction of patients and their families.