放射性脑病认知功能障碍的康复性治疗研究

目的 评估认知康复治疗对放射性脑病导致的认知功能障碍的治疗作用及存在问题。方法 回顾性研究既往63 例确诊为放射性脑病出现认知功能障碍的患者，按是否接受认知康复治疗分为治疗组（认知康复治疗＋神经营养药物34例）和对照组（神经营养药物29例）。治疗组除神经营养药物治疗外，每天认知康复治疗2次，每次30 min，共治疗12周。每组于治疗前和治疗后采用蒙特利尔认知功能检查量表（MoCA）和简易精神状态量表（MMSE）进行认知功能的评定。结果 治疗前2组患者MoCA评分、MMSE评分差异均无统计学意义（P>0.05）。治疗12周后，治疗组比对照组患者MoCA总分和MMSE总分增加，差异均有统计学意义（t=5.20、3.18，P<0.01）。而且在视空间、命名、注意、抽象思维、延迟回忆、定向各方面均有提高，差异均有统计学意义（t=-3.51、-3.09、-3.18、-2.57、-3.52、-3.39，P<0.05）。结论 在常规用药基础上辅以认知康复治疗，能进一步提高放射性脑病患者的认知能力。

Efficacy of cognitive rehabilitation in patients with cognitive dysfunction caused by radiation-induced encephalopathy

Objective To evaluate the efficacy and safety of cognitive rehabilitation in the treatment of cognitive dysfunction caused by radiation-induced encephalopathy. Methods A total of 63 patients with radiation-induced cognitive impairment were divided into treatment group (cognitive rehabilitation combined with conventional therapy) and control group (conventional treatment alone) for 12 weeks. The cognitive function was assessed according to Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) before and after 12 weeks treatment. Results After 12 weeks treatment, the patients in treatment group demonstrated significant improvement in cognitive function. In treatment group, the scores of patients after cognitive rehabilitation in MoCA and MMSE were obviously higher than the control group(t=5.20, 3.18, P<0.01). The scores in the visual space, naming, attention, abstract thinking, delayed memories and orientating also had improved, with statistically significant difference(t=-3.51,-3.09,-3.18,-2.57,-3.52,-3.39, P<0.05). Conclusions Cognitive rehabilitation combined with conventional treatment was signally effective in the therapy of cognitive dysfunction caused by radiation-induced encephalopathy.