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背景:由于丘脑与认知功能有关,如何对丘脑性失语进行语言康复训练,是很多康复工作者关心的热点问题之一。目的:探讨认知功能训练对丘脑失语患者的治疗作用。设计:病例分析。单位:河南省新乡市中心医院神经内科。对象:选取1999-06/2002-08在新乡市中心医院神经内科住院的均经头颅CT、MRI证实为丘脑卒中的患者30例,这些患者均伴有失语及认知功能障碍,均为高中毕业,其中男16例,女14例;脑出血13例,脑梗死17例,随机分为治疗组和对照组,每组15例。方法:所选病例均进行神经内科常规药物治疗,包括抗炎、限液、脱水、支持等治疗。两组均接受语言训练,包括听理解训练、口语表达训练、阅读训练、书写训练(一对一方式,1次/d,30min/次),治疗组患者在此基础上接受认知神经心理法训练(一对一方式,1次/d,45min/次),共治疗2个月。治疗前后语言能力的评估选用北京医科大学附属第一医院神经内科的标准化汉语失语检查法中有代表性的7个项目(信息量、流利性、复述、是非题、听辨认、口头指令、选词填空)进行评估。采用简易精神状态量表评估认知功能。主要观察指标:两组患者治疗前后信息量、流利性、是非题、复述、听辨认、口头指令、选词填空、简易精神状态量表得分。结果:30例患者全部进入结果分析。治疗组与对照组治疗前在语言及认知功能评分方面差异无显著性意义(P>0.05)。治疗后治疗组语言功能及认知功能恢复程度均较对照组差异有显著性意义(P<0.05)。其中复述、听理解能力评分明显高于对照组[(72.6±24.5),(41.2±16.1)分;(63.7±17.8),(35.8±14.9)分,P<0.01]。结论:丘脑性失语患者进行语言训练的同时进行认知训练可提高语言恢复能力,在进行语言训练时,应将认知训练纳入失语患者常规治疗中。
Background: As the thalamus is related to cognitive function, how to train the language rehabilitation of thalamic aphasia is one of the hot issues that many rehabilitation workers are concerned about. Objective: To investigate the therapeutic effect of cognitive training on thalamic aphasia patients. Design: Case Analysis. SETTING: Department of Neurology, Xinxiang Central Hospital, Henan Province. PARTICIPANTS: Thirty patients were selected from Department of Neurology, Xinxiang Central Hospital, from June 1999 to August 2002, all of whom were confirmed to be cerebral apoplexy by skull CT and MRI. These patients were all accompanied by aphasia and cognitive dysfunction. All of them were high school graduates , Including 16 males and 14 females; 13 cases of cerebral hemorrhage and 17 cases of cerebral infarction were randomly divided into treatment group and control group, 15 cases in each group. Methods: The selected cases were treated with conventional medical treatment of neurology, including anti-inflammatory, fluid, dehydration, support and other treatment. Both groups received language training, including listening comprehension training, oral expression training, reading training, writing training (one-on-one, 1 time / d, 30min / time). Patients in the treatment group received cognitive neuropsychological method Training (one-on-one mode, 1 time / d, 45min / time) for a total of 2 months. The assessment of linguistic competence before and after treatment was performed on seven representative items of standardized Chinese aphasia test (Department of Neurology, First Affiliated Hospital of Beijing Medical University) (informative, fluent, repeat, non-question, Fill in the blank) for evaluation. Assessment of cognitive function using mental state scale. MAIN OUTCOME MEASURES: The two groups of patients before and after treatment of information, fluency, non-issue, repeat, listen to recognize, verbal instructions, word fill in the blank, simple mental state scale score. Results: All 30 patients entered the result analysis. There was no significant difference between the treatment group and the control group in language and cognitive function scores before treatment (P> 0.05). After treatment, the degree of recovery of language function and cognitive function in the treatment group was significantly higher than that in the control group (P <0.05). The scores of repetition and listening comprehension were significantly higher than those of the control group [(72.6 ± 24.5), (41.2 ± 16.1) points, (63.7 ± 17.8), (35.8 ± 14.9) points, P <0.01]. CONCLUSION: The training of thalamic aphasia in language training and cognitive training at the same time can improve the ability of language recovery. In language training, cognitive training should be included in the routine treatment of aphasia.