脑卒中认知障碍早期识别和康复护理研究

目的研究脑卒中患者认知障碍的早期临床反应及认知康复训练的临床效果。方法121例患者病情得到控制后的1个月时间内定期观察病人注意力、记忆力、情感、思维及智力等认知功能变化情况,63例认知障碍患者随机分为认知训练组(32例)及常规康复训练组(31例),训练2个月后分别用简易智能状态检查(mini-mental state examina-tion,MMSE)量表、Barthel及神经功能缺损指数对患者认知、运动功能分级及日常生活活动能力进行评定。结果认知障碍患者病情稳定后5~7天左右出现注意力分散及记忆力下降趋势,且下降趋势明显,12~17天左右出现情感淡漠、思维淡漠及智力下降等认知功能障碍。两组患者训练2个月后,认知训练组的MMSE评分、Barthel及神经功能缺损指数均明显改善,优于常规康复训练组(P<0.05或P<0.01)。结论脑卒中早期认知障碍的识别及认知行为康复训练对早期诊断、病情的改善进展有非常重要的应用价值。

Early identification and rehabilitation on stroke patients with cognitive disorders

Objective To study the early identification and the effectiveness of cognitive rehabilitation on patients with stroke associated with cognitive disorders.Methods The attention,memory,emotion,thinking and intelligence of 121 patients were regularly observed within one month after stroke-control.63 cases of them with cognitive disorders were randomly divided into cognitive training group(32 cases) and conventional rehabilitation training group (31 cases).Mini Mental State Examination(MMSE),modified Barthel and neurological deficit index were used to evaluate the two groups of patients' cognition,movement function and daily life ability after 2-month training.Results Patients with cognitive disorders occurred distraction,memory decline after 5～7 days of stroke stability,emotional indifference,apathy and intellectual decline after 12～17 days of stroke stability.The differences in the assessment of MMSE,Barthel and neurological deficit index between the two groups after 2-month training were significant(P<0.05 or P<0.01).Cognitive training group was superior to conventional rehabilitation training group.Conclusion Early identification and cognitive rehabilitation training play important roles on early diagnosis and improving the progress of disease on patients with stroke associated with cognitive disorders.