血管性认知功能障碍的严重程度对脑卒中后偏瘫患者功能结局的影响

关键词：脑血管意外 认知障碍 血管性痴呆

Keywords:cerebrovascular accident  cognitive impairment  vascular dementia

摘要：

      目的：分析脑卒中后血管性痴呆（VD）和无痴呆的血管性认知功能障碍（VCIND）患者认知功能、运动功能、ADL能力在训练后的恢复情况,比较两者的康复效益。方法：将符合入选条件的患者分为VD组（n=30例）和VCIND组（n=34例）,两组患者均进行认知训练、运动功能及ADL训练。在训练前后用神经行为认知状况评估量表（NCSE）、简化Fugl-Meyer运动功能评分表、Barthel指数（BI）进行相应的评价,采用ADL能力的改善值与住院天数比值进行康复效益评定。结果：VCIND组训练前在注意力、计算力、结构组织能力、记忆力评分低于正常值,VD组认知功能的各项评分均低于正常值,训练后与训练前比较,VCIND组定向力、注意力、语言理解、结构组织、记忆、判断力等项目分值的提高差异有显著性意义,VD组定向力分值的提高差异有显著性意义。VD组和VCIND组训练前Fugl-Meyer评分和Barthel指数的差异无显著性意义,训练后上述分值的差异有显著性意义。VCNID组运动功能的改善及认知可能的改善比VD组明显,VCIND组的康复效益值比VD组高。结论：VCIND组的康复训练比VD组疗效好,康复效益高。

Abstract:

      Objective: To evaluate the functional outcome of patients stroke of vascular cognitive impairment without dementia(VCIND) and dementia(VD), and to compare the cognitive function, motor function, ADL and rehabilitation efficacy after training. Method: Sixty-four participants were divided into VD(n=30) and VCIND(n=34) groups. Both groups received cognitive training, physical therapy and ADL training. The neurobehavioral congnitive status exam assessment was used to assess cognitive function. The Fugl-Meyer motor assessments were used to assess motor function,the Barthel index were used to assess ADL and the rehabilitation efficacy was evaluated by the ratio of the changed value of ADL to the hospitalized days. Result: Before the trainings, some cognitive function of VCIND was lower than normal value, such as attention, construction, memory and calculation. All parameters in VD group were lower than normal value. After training, attention,orientation,construction,memory,judgement.comprehension were superior in VCIND, only orientation was superior in VD. The improvement of motor functions and ADL in VCIND were better than VD. The rehabilitation efficacy in VCIND was superior to VD. Conclusion: The functional outcome of VCIND is better than VD.