记忆障碍的康复

记忆是人脑的重要高级功能之一，与学习关系密切，前后相承，均为智力构成的重要因素。记忆障碍是临床上器质性脑损害患者的常见主诉，影响一个人的学习、工作和社会交往水平．甚至是日常生活活动能力。所以对记忆障碍的康复非常重要。本文从记忆的分类、机制和记忆障碍的康复评定、康复治疗等方面进行综述。     

记忆障碍的康复

记忆障碍是脑外伤、脑卒中、老年性痴呆等患者最普遍的认知功能损害。目前国内外学者采用不同方法针对脑损伤患者的记忆障碍进行康复训练,取得了一定的进展。本文对近年有关记忆障碍康复的方法及疗效做一综述,初步探讨最佳的康复治疗方案。     

脑卒中病人记忆障碍康复护理效果评价

选取2012年11月~2013年10月我院收治的45例脑卒中患者。根据护理方式的不同将患者分为观察组25例和对照组20例。观察组患者给予常规护理与综合记忆护理,对照组患者给予常规护理。比较两组护理效果。结果护理干预后观察组患者MMSE以及CMS评分均明显高于对照组,两组差异显著,具有统计学意义(P0.05)。对脑卒中病人记忆障碍患者行常规护理与综合记忆护理能够有效提高患者的记忆能力。     

认知功能训练对脑损伤后记忆障碍的影响

目的探讨认知功能训练对脑损伤后记忆障碍的影响及临床意义。方法将82例脑损伤患者设为研究组,79例同期来本院体检的健康人设为对照组,研究组在常规治疗护理的基础上给予5周的认知功能训练,在训练前,训练后分别进行韦氏记忆量表(WMS)测评。结果脑损伤后训练前,患者的长时记忆、短时记忆、瞬时记忆的各项分测验评分,以及记忆智商均明显低于对照组(P<0.05)。5周训练后WMS测评中,除回忆与训练前无显著差别外,其他各项分测验值以及记忆智商均明显优于训练前(P<0.05)。结论脑损伤后患者的记忆功能明显受到损害,早期认知功能训练可改善记忆障碍。     

无错性学习在记忆障碍康复中的应用

记忆障碍也称遗忘症，是脑血管意外、脑外伤和老年性痴呆等疾病的常见后遗症，也是阻碍这些疾病全面康复的最主要原因之一。目前国外学者对无错性学习治疗记忆障碍在基础与治疗研究方面都取得了一定进展。本文回顾了有关文献，就无错性学习在记忆障碍训练方面的应用略作介绍。     

记忆障碍的康复治疗(综述)

记忆障碍也称遗忘症 ,是脑血管意外、脑外伤和老年性痴呆等疾病的常见后遗症 ,也是阻碍这些疾病全面康复的最主要原因之一。目前国内外学者对记忆障碍康复治疗的研究取得了一定进展 ,同时也面临着许多新问题。本文就有关记忆障碍评估与治疗的现状综述如下。1　记忆的 3个阶段[1,2 ]1.1　感觉记忆　一般分为视觉记忆和听觉记忆 ,目前的研究以视觉记忆为主。视觉记忆一般只持续约 2 5 0～ 5 0 0ｍｓ ,于 2 5 0ｍｓ后即开始消失。1.2　短时记忆　进入短时记忆的信息可持续约2 0～ 30ｓ,其信息储存量是有限的 ,约为 7± 2个单位 ,它是以复习和听…     

脑外伤认知障碍的康复治疗进展

近年来，认知康复在脑外伤急性期和急性期之后的康复治疗中，越来越受到临床医生的重视。虽然脑外伤后认知障碍有一个自然恢复的过程，但适当的干预仍是至关重要的。临床上常见的脑外伤后的认知障碍主要表现在注意力和觉醒障碍、记忆障碍、感觉知觉功能障碍、智力和执行功能障碍、行为情绪和人格的变化等方面。本文就脑外伤后认知障碍的康复治疗的现状及进展综述如下：     

脑卒中患者记忆障碍的原因探讨

目的：从神经心理学角度对脑卒中患者记忆减退的机制进行探讨,为卒中后记忆功能的康复提供帮助。方法：对５９例脑卒中患者及３０例无脑器质笥疾病进行记忆商评定,并对记忆结果进行比较。结果：卒中组５４．２％的患者有非指向词的混杂记忆,对照组为３０％,差异有显著性。与对照组相比注意障碍组（Ａ组）ＭＱ及各项测验成绩均显著降低,无注意障碍组（Ｂ组）仅图像自由回忆一项成绩降低有显著意义。Ａ、Ｂ组之间指向记忆、联想学     

早期康复治疗对脑卒中患者认知功能障碍的影响分析

目的:探讨早期康复治疗对脑卒中患者认知功能障碍的影响。方法:选取2017年5月～2018年5月我院收治的脑卒中患者60例,根据随机数字表法分为对照组与研究组各30例。对照组接受常规治疗,研究组在对照组基础上接受早期康复治疗。观察两组治疗前后认知功能障碍程度、日常生活活动能力以及神经功能缺损情况。结果:治疗前,两组MMSE、CSS及MBI评分比较差异无统计学意义(P0.05);治疗后,研究组MMSE及MBI评分高于对照组,CSS评分低于对照组(P0.05)。结论:对脑卒中患者展开早期康复治疗,能明显改善患者认知功能障碍,提高其生活质量,值得临床广泛应用。     

失语症的康复治疗

目的:综述失语症的类型及其康复治疗现状,为促进失语症患者言语功能的恢复提供一定的理论依据和实践指导。资料来源:应用计算机检索中国期刊网1994-01/2006-04有关失语症和言语治疗的文献,检索词“失语症、言语治疗、康复”,并限定文章的语言种类为中文。同时手工检索相关书籍。资料选择:对资料进行初审,选取试验包括采用Schuell刺激法、旋律语调治疗、实用交流训练等治疗组和对照组的命名、阅读、听理解、复述变化比较的相关文献,删除明显不随机临床试验的研究,然后查找余下的文献全文,进一步判断是否为随机对照实验。质量评价主要考察资料的真实性,调查设计是否严密,实施过程是否严格,统计学处理是否合理。资料提炼:共检索45篇关于失语症的康复治疗文献,30篇符合纳入标准,排除的15篇为重复研究。资料综合:根据国内外通用的解剖-临床相关基础分类,失语症的类型主要有8种:Broca失语、Wernicke失语、传导性失语、经皮质运动性失语、经皮质感觉性失语、经皮质混合性失语、完全性失语、命名性失语。失语症康复治疗方法主要包括语言治疗技术、功能性交流治疗、认知神经康复治疗、社交心理治疗、计算机辅助治疗等。结论:失语症类型多样,应针对言语功能障碍选择适宜的言语康复治疗方法,或采用综合的治疗措施,这有利于提高失语症的治疗效果。     

不同部位病变所致记忆障碍的表现

记忆障碍是常见的临床问题 ,是复杂的器质性或心因性问题的一部分。系统研究与记忆有关的解剖部位和结构 ,对我们了解记忆功能在脑内的定位具有十分重要的意义。1记忆的定义及分类记忆是指获得的信息或经验在脑内储存和提取的神经过程 ,是有意义地追忆经历。人类记忆是相当复杂的认知功能 ,可分为编码、储存和提取 3个独立而又相互作用的基本过程。记忆可分为短时记忆和长时记忆两种。短时记忆又分为影像记忆 (ｉｃｏｎｉｃｍｅｍｏｒｙ)、即刻记忆 (ｉｍｍｅｄｉａｔｅｍｅｍｏｒｙ)、初级记忆 (ｐｒｉｍａｒｙｍｅｍｏｒｙ)、工作记忆 (ｗ…     

Occupational therapy for adults with perceptual deficits

Although perceptual retraining has for many years been an accepted part of occupational therapy for adults with perceptual problems stemming from brain injury, few outcome studies on this type of treatment have been conducted. To assure high-quality, cost-effective rehabilitation programs for this population, occupational therapists need to do more research to (a) precisely define perceptual interventions and (b) determine the efficacy of different occupational therapy approaches to perceptual problems. This article offers guidance on the design of future studies to achieve the latter goal by exploring the current research on the effectiveness of perceptual remediation and offers suggestions for future research.     

Occupational therapy treatments for constructional deficits.

Occupational therapists use both adaptive and remedial approaches to perceptual retraining in adults with head injury. This experimental treatment outcome study compared the effects of adaptive and remedial treatments for constructional deficits on meal preparation competence and on constructional abilities in adult men with head injury. Forty-five subjects, 18 to 52 years of age, in long-term rehabilitation programs were randomly assigned to one of two treatment groups. A remedial group (n = 22) received individual training with parquetry block assembly, and an adaptive group (n = 23) received individual training in food preparation activities. Both groups received training for three 30-min sessions per week for 6 weeks, in addition to their regular rehabilitation programs. Results of analyses of variance and paired t tests on perceptual and functional test scores showed task-specific learning in both groups and suggested that training in functional activities may be the better way to improve performance in such activities in this population.     

Parvalbumin interneuron loss mediates repeated anesthesia-induced memory deficits in mice

Repeated or prolonged, but not short-term, general anesthesia during the early postnatal period causes long-lasting impairments in memory formation in various species. The mechanisms underlying long-lasting impairment in cognitive function are poorly understood. Here, we show that repeated general anesthesia in postnatal mice induces preferential apoptosis and subsequent loss of parvalbumin-positive inhibitory interneurons in the hippocampus. Each parvalbumin interneuron controls the activity of multiple pyramidal excitatory neurons, thereby regulating neuronal circuits and memory consolidation. Preventing the loss of parvalbumin neurons by deleting a proapoptotic protein, mitochondrial anchored protein ligase (MAPL), selectively in parvalbumin neurons rescued anesthesia-induced deficits in pyramidal cell inhibition and hippocampus-dependent long-term memory. Conversely, partial depletion of parvalbumin neurons in neonates was sufficient to engender long-lasting memory impairment. Thus, loss of parvalbumin interneurons in postnatal mice following repeated general anesthesia critically contributes to memory deficits in adulthood.     

Memory impairment and awareness of memory deficits in early-stage Alzheimer's disease

In addition to their memory impairment, individuals with Alzheimer's disease (AD) often suffer from deficits in self-awareness. Awareness of memory deficits or metamemory is a multifaceted function, comprising on-line self-monitoring, generalized self-beliefs of memory efficacy, and generalized knowledge about memory functions. Awareness of memory problems in early-stage AD is a matter of clinical importance from a humanistic point of view, because higher levels of awareness may be associated with better future outcomes. Current methods of measuring awareness tend to fall into two categories, i.e., to introduce a questionnaire assessing patient/caregiver discrepancies; or to ask a patient to prospectively predict or retrospectively postdict their own memory performances. Characteristics of each measure as well as relationship between the two measures were discussed. For the performance prediction/postdiction paradigm, we used recognition memory of auditory verbal learning tests and awareness of memory deficits were examined in 24 individuals with early-stage AD. In addition to their significantly impaired recognition memory, individuals with AD displayed underawareness of memory deficits even at this early stage. They retrospectively overestimated memory performance after actual performance, but appeared to benefit from feedback and displayed intact on-line awareness of memory dysfunction, leading to normal prediction of the second session. However, individuals with AD again failed to retrospectively incorporate incidents of memory failure into generalized self-belief systems. Brain/behavior correlational analyses suggest that the prefrontal cortex and posterior dorsomedial regions including the precuneus may be involved in self-awareness.     

The vocational situation in cases of memory deficits or younger-onset dementia

The aim of the study was to describe how persons with memory deficits or younger-onset dementia perceived and met their problems, with particular reference to their present and future vocational situation, including describing the parallel observations and attitudes of other significant persons in the vocational context. Data were collected through 16 interviews, one with each of nine subjects and seven respondents from the subjects' work-places. All interviews were analysed with a comparative method, searching for themes. In addition, subjects' IADL (instrumental activities of daily living) ability and cognition were assessed. The findings demonstrated that the subjects themselves experienced extensive difficulties before their predicament was defined. The difficulties were met by spontaneous and planned strategies on the part of the subjects and by adaptations at the workplaces, but with limited success. The situation also profoundly affected fellow workers. Overall, both the subjects and the work-place respondents had a positive attitude to continued work as long as the subjects made useful contributions. The possibility of remaining in work seemed to depend on multiple factors, including the individual's apprehension of his or her own ability and the length of the sick-leave.     

肾移植后的康复运动治疗

背景：肾移植是目前治疗终末期肾脏疾病最有效的方法,肾移植后期康复运动治疗对于改善患者的精神状态,提高患者生活质量具有重要意义。目的：分析肾移植后康复运动治疗的方法及意义,促进肾移植患者精神及心理的恢复,从而改善患者的生活质量。方法：给予肾移植后康复期患者运动治疗,制定合理的治疗方案,分析康复运动对肾移植后患者躯体健康及心理健康的治疗效果,明确康复运动治疗对机体各方面的作用影响。结果与结论：给予肾移植后康复期患者康复运动治疗,可以减少患者焦虑、抑郁等精神症状,促进患者生理和心理健康的恢复,有利于患者对社会功能的适应,并且同时还可以辅助调节体质量、血压、血脂、血糖等变化,辅助预防心脑血管疾病的发生,明显改善其生活质量。