综合康复护理对脑梗死轻度认知功能障碍的疗效观察

目的：探讨综合康复护理手段对脑梗死后认知功能障碍的疗效。方法：对2012年1月至10月首次脑梗死患者，采用多维度认知功能量表筛选出60例轻度认知功能障碍患者，设干预组30例，对照组30例。干预组在常规护理基础上进行系统的康复训练，包括注意力训练、计算力训练、记忆力训练、定向力训练、语言功能训练、视空间与执行功能训练；对照组提供常规护理。4周后再运用多维度认知功能量表全面评估两组患者。结果：两组患者在干预前性别、年龄、文化程度及多维度认知功能量表各项目差异无统计学意义（P〉0．05）。干预后复评除Stroop色词测验（SCWT）、画钟测验（CDT）差异无统计学意义（P〉0．05）外，Rey—Osterrich复杂图形测验（CFT）、CFT-延迟回忆、逻辑记忆测验（LMT）、数字广度测试（DS）、语义相似性测验、听觉词语学习测验（AVLT）、数字符号转换测验（DSST）、听觉词语学习测验（AVLT）-5min延迟、AVLT-20min延迟再认、言语流畅性测试（Vrr）、连线测验A（TMT-A）、连线测验B（TMT。B）、图片命名测验等差异均有统计学意义（P〈0．01）。结论：在脑梗死患者早期进行系统的综合康复护理训练可有效改善患者的认知功能，临床上应充分重视该类患者的早期认知干预，将系统的综合康复护理训练方法作为常规护理。

Effect of comprehensive rehabilitation nursing on mild cognitive dysfunctions after cerebral infarction

Objective： To explore the efficacy of comprehensive rehabilitation nursing on cognitive dysfunctions after cerebral infarction. Methods： Full-scale neuropsychological tests were used to recruit 60 mild cognitive impairment patients in the subjects of first occurrence of cerebral infarction. Then, 30 patients with comprehensive rehabilitation nursing and 30 controls without rehabilitation nursing were further randomly separated. Rehabilitation nursing group completed both routine nursing and systematic rehabilitation training, including attention, computing, memory, orientation, language, visuospatial and executive function; controls only received routine nursing. All groups finally completed a follow-up full-scale neuropsychological tests scan at four weeks. Results： Both groups in age, sex, educational level and the performance of neuropsychological tests were not significantly different at baseline （ P 〉 0.05 ）. Compared to controls, the greater improvement of almost all cognitive functions was observed in rehabilitation nursing group during follow up, Rey-Osterrieth complex figure test（ CFT）, CFT-delayed recall, Logic memory test, Digit span test, Semantic similarity test, Auditory verbal learning test （AVLT）, AVLT- 5 min and 20 min delayed recall, Verbal fluency test, Trail making test-A and-B, Picture naming test（P 〈 0.01 ）. Conclusions： Early comprehensive rehabilitation nursing can effectively improve cognitive dysfunctions in patients of cognitive dysfunctions after cerebral infarction. The clinical importance of comprehensive rehabilitation nursing should be highlighted and could be added into routine nursing.