程义仙 余建香 戚东静 余国峰

[摘要] 目的 探讨认知康复训练在改善颅脑损伤患者认知功能及生存质量中的应用。 方法 选取2015年1月～2017年5月颅脑损伤伴认知功能障碍患者86例，随机分为干预组和对照组。两组在药物治疗基础上给予常规康复干预，干预组再加认知康复训练。两组均干预8周。评估并比较两组干预前后认知功能指标[简明精神状态量表（MMSE）、洛文斯顿成套测验量表（LOTCA）和记忆商（MQ）评分]及生存质量变化。 结果 干预8周后，两组MMSE、LOTCA评分和MQ评分均有不同程度上升（P<0.05或P<0.01），且干预组上升幅度较对照组更明显（P<0.05）；干预8周后，两组心理健康、生理健康、环境关系与社会关系等生存质量评分均有不同程度上升（P<0.05或P<0.01），且干预组上升幅度较对照组更明显（P<0.05）。 结论 认知康复训练用于颅脑损伤伴认知功能障碍患者可延缓其认知障碍的发生，改善其认知功能，并可提高其生存质量，改善其预后。

[关键词] 颅脑损伤；认知康复训练；认知功能；生存质量

[中图分类号] R651.1+5 [文献标识码] B [文章编号] 1673-9701（2018）07-0086-03

[Abstract] Objective To investigate the application of cognitive rehabilitation training in improving cognitive function and quality of life in patients with craniocerebral injury. Methods 86 craniocerebral injury patients with cognitive impairment from January 2015 to May 2017 were randomly divided into intervention group and control group. The two groups were given routine rehabilitation intervention on the basis of drug treatment. And the intervention group was also given cognitive rehabilitation training. Both groups were intervention for 8 weeks. The changes of cognitive function indicators including mini-mental state examination（MMSE）， the Loewenstein occupational therapy cognitive assessment（LOTCA） and memory quotient（MQ） score and quality of life before and after intervention were evaluated and compared between the two groups. Results After 8 weeks of intervention， the scores of MMSE， LOTCA and MQ in both groups increased to some extent（P<0.05 or P<0.01）， and the increase rate in intervention group was more obvious than that in control group（P<0.05）. The scores of quality of life including mental health， physical health， environmental relations and social relations were increased to some extent after 8 weeks of intervention（P<0.05 or P<0.01）. The increase rate in the two groups was more significant than that in the control group（P<0.05）. Conclusion Cognitive rehabilitation training for craniocerebral injury patients with cognitive impairment can delay the cognitive impairment， improve their cognitive function，their quality of life and their prognosis.

[Key words] Craniocerebral injury；Cognitive rehabilitation training；Cognitive function；Quality of life

顱脑损伤是临床常见的急重症，病情较危重，治疗后致残率及病死率较高，即使存活后也会留有不同程度神经系统后遗症，其中认知功能障碍较为常见，对日常工作及生存质量影响较明显[1，2]。以往对颅脑损伤治疗主要重视早期生命抢救，而忽视后期遗留神经后遗症的早日康复。近年来虽然对神经后遗症有所重视，但也主要集中于患肢体功能和语言功能康复，而对认知功能障碍的康复方面干预研究相对较少[3，4]。认知康复训练是对获得性脑损伤而导致认知功能下降而采取的综合性康复训练干预方法，在颅脑损伤伴认知功能障碍患者中的应用国内外鲜有报道[5，6]。本研究分析了认知康复训练在改善颅脑损伤患者认知功能及生存质量中的应用，现报道如下。

1 资料与方法

1.1 一般资料

选取2015年1月～2017年5月在我院住院治疗颅脑损伤伴认知功能障碍患者86例。……