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目的观察心理及行为干预对脑卒中后认知功能障碍患者的应用效果。方法将急性脑卒中入院且伴认知功能障碍后遗症的90例患者,按照随机数字表法将患者分为观察组和对照组。对照组:采用康复治疗办法;观察组:康复治疗基础上,辅以行为与心理康复干预。通过为期5个月的治疗,采取慢性精神病患评定量表(SSPI)、社会功能缺陷筛选量表(SDSS)、认知功能评定量表(MMSE)、抑郁自评量表(SDS)、病耻感应对量表COR量表针对患者社会功能障碍、认知功能障碍以及负性情绪发生情况,以量表的形式对脑卒中患者认知功能障碍情况进行量化评估。结果两组患者治疗前SSPI、SDS、COR及MMSE、SDSS量表评分均无统计学差异(P>0.05)。经治疗,两组患者SSPI、SDS、COR量表评分均显著降低(P<0.05),其中观察组患者各评分显著低于对照组(P<0.05);观察组MMSE评分均显著高于治疗前及对照组,SDSS显著低于治疗前及对照组(P<0.05);对照组MMSE评分与治疗前无显著差异(P>0.05),SDSS评分显著低于治疗前(P>0.05)。结论脑卒中后遗认知功能障碍患者行为与心理干预有助于健全社会功能、缓解负性情绪,对患者早期精神失常与认知功能障碍有显著的康复效果。
Objective To observe the effect of psychological and behavioral intervention on patients with cognitive dysfunction after stroke. Methods Ninety patients admitted to hospital with acute stroke and cognitive impairment were divided into observation group and control group according to random number table method. Control group: rehabilitation therapy; observation group: rehabilitation therapy, supplemented by behavioral and psychological rehabilitation intervention. Through 5-month treatment, chronic mental illness rating scale (SSPI), social function defect screening scale (SDSS), cognitive function scale (MMSE), depression self-rating scale (SDS) The shame coping scale COR scale for patients with social dysfunction, cognitive dysfunction and the occurrence of negative emotions, cognitive impairment in patients with stroke in the form of quantitative assessment of cognitive disorders. Results There was no significant difference in scores of SSPI, SDS, COR, MMSE and SDSS between the two groups before treatment (P> 0.05). After treatment, the score of SSPI, SDS and COR in the two groups were significantly decreased (P <0.05), and the scores in the observation group were significantly lower than those in the control group (P <0.05); the MMSE scores in the observation group were significantly higher than those before treatment (P <0.05). The MMSE score of the control group was not significantly different from that before treatment (P> 0.05). SDSS score was significantly lower than that before treatment (P> 0.05). Conclusion Behavioral and psychological interventions in patients with cognitive impairment after stroke contribute to the improvement of social functions and the relief of negative emotions, and have significant rehabilitation effects on patients with early mental disorders and cognitive dysfunction.