Loewenstein认知评定量表与简易精神状态量表对心脏手术患者认知功能评估的比较

目的 通过与简易精神状态量表(MMSE)的比较,评估Loewenstein认知评定量表(LOTCA)是否能用于术后认知障碍(POCD)的诊断与研究. 方法 对山东省立医院心外科自2010年10月至2011年3月行心脏瓣膜置换术的30例患者,分别于术前1d和术后7d使用MMSE、LOTCA行神经心理学测评患者的认知功能,分析比较二者对POCD的诊断率、MMSE和LOTCA评分及检测时间的差异. 结果 患者采用MMSE测评诊断POCD 13例(43.33％),采用LOTCA测评诊断POCD 17例(56.67％),诊断率比较差异无统计学意义(x2=1.067,P=0.302).与术前1d比较,术后7d患者MMSE总分、LOTCA总分、LOTCA评分中4个子项目(动作运用、视运动组织、思维操作、注意力及专注力)得分降低,差异均有统计学意义(P＜0.05).患者MMSE总分与LOTCA总分呈正相关关系(γ=0.711,P=0.005).与MMSE的测评时间比较、患者术前1d和术后7d LOTCA的测评时间均较高,差异有统计学意义(P＜0.05). 结论 LOTCA可以用于POCD的诊断与研究,能够较MMSE更全面的评估患者的认知功能,但耗时较长.

Loewenstein occupational therapy cognitive assessment and mini-mental state examination in evaluating the cognitive function of patients received cardiac surgery:a comparative study

Objective To evaluate whether Loewenstein occupational therapy cognitive assessment (LOTCA) can be used in the diagnosis of postoperative cognitive dysfunction (POCD) by comparing it with mini-mental state examination (MMSE).Methods Thirty patients performed cardiac valve replacement surgery in our hospital from October 2010 to March 2011 were chosen; the cognitive function of these patients were neuropsychologically evaluated by MMSE and LOTCA 1 d before and 7 d after the surgery; the differences of accurately diagnostic rate on POCD,the scores and the time-consuming when MMSE and LOTCA were chosen were compared.Results Thirteen patients (43.33％) were diagnosed as having POCD by MMSE and 17 patients (56.67％) by LOTCA; the difference of accurately diagnostic rate on POCD was not statistically significant (x2=1.067,P=0.302).MMSE scores,LOTCA scores and scores of 4 subtests (motor praxis,visuomotor organization,operation of thinking,and attention and concentration) 7 d after the surgery was significantly decreased as compared with those 1 d before the surgery (P＜0.05).MMSE scores were highly correlated with LOTCA scores (γ=0.711,P=0.005).Conclusion LOTCA can be used in the diagnosis and research of POCD.It can do a more comprehensive assessment than MMSE in cognitive function with longer times.