颅脑创伤患者记忆障碍比较研究

目的探讨不同类型颅脑创伤患者记忆障碍的特征。方法根据患者入院时GCS评分,按创伤严重程度将42例颅脑创伤患者分为轻度创伤组(GCS13～15分,16例)、中度创伤组(GCS9～12分,14例)和重度创伤组(GCS3～8分,12例)。采用临床记忆量表进行短时记忆测量并与42名健康受试者(对照组)进行比较,观察冲击点伤、对冲伤、混合伤及加速伤、减速伤、混合伤、切线伤对颅脑创伤患者记忆力的影响。结果与对照组相比,不同程度颅脑创伤患者的记忆商(MQ)均显著下降,其中轻度创伤组与中、重度创伤组相比,差异具有显著性意义(P<0.05);冲击点伤、对冲伤以及混合伤患者之间MQ相比,差异具有显著性意义(P<0.01),冲击点伤患者的MQ值最高(P<0.05);加速伤、减速伤、混合伤和切线伤患者之间MQ相比,差异亦有显著性意义(P<0.01)。结论颅脑创伤后混合伤和切线伤对患者记忆的影响最为明显。

Comparative study on memory deficits in patients after traumatic brain injury

Objective To study the characteristics of memory deficit in patients after different types of traumatic brain injury (TBI). Methods Forty-two patients with TBI were divided into minor (GCS 13-15, n=16), moderate (GCS 9-12, n=14) and severe (GCS 3-8, n=12) injury groups according their Glasgow coma scale at admission. The clinical memory scale was adopted to measure the transient memory of the patients and compared with that of 42 healthy subjects in control group. The effects of coup injury, contre-coup injury, complex injury, acceleration injury, deceleration injury, complex injury and tangent injury on memory of patients after TBI were observed. Results The memory quotient (MQ) of patients in different groups of TBI was significantly decreased than that in control group, and the differences of MQ between the minor injury group and moderate or severe injury group were statistically significant (P < 0.05). The differences of MQ between coup injury group and contre-coup injury, or complex injury group were also significant (P < 0.01), but it is most significant (P < 0.05) in coup injury group. The significant differences were also found between the patients with acceleration injury and deceleration, complex injury or tangent injury (P < 0.01). Conclusion It shows that there is the most obvious effect on memory in patients with complex and tangent injury after TBI.