| 孙良文,余文男,韦春霞,刘淼,卢敏,段强,覃东,黄肖群.基于丰富环境理念的远程家庭康复指导治疗社区居住脑卒中非痴呆型认知障碍患者的疗效观察[J].中国康复,2021,36(10):594-598 |
| 基于丰富环境理念的远程家庭康复指导治疗社区居住脑卒中非痴呆型认知障碍患者的疗效观察 |
| Therapeutic effect of tele-rehabilitation guidance based on the concept of enriched environment in the non-dementia cognitive impairment residential stroke patients |
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| DOI： |
| 中文关键词: 丰富环境 远程家庭康复 脑卒中后非痴呆型认知障碍 事件相关电位 工具性日常生活能力 |
| 英文关键词: enriched environment tele-rehabilitation guidance post-stroke cognitive impairment no dementia event-related potential instrumental activity of daily living |
| 基金项目:湖北省卫生健康科研基金资助（WJ2019H502）；湖北省宜昌市科技局科技计划项目（A20-2-019）；三峡大学科学基金青年科学基金项目（KJ2018A010） |
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| 中文摘要: |
| 目的：探讨基于丰富环境（EE）理念的远程家庭康复指导对社区居住脑卒中后非痴呆型认知障碍（PSCIND）患者认知功能、心理情绪及日常生活能力的影响。方法：采用随机数字表法将68例PSCIND患者随机分为对照组33例和观察组35例，对照组出院前给予常规康复宣教及定期门诊复诊指导，观察组在此基础上加基于EE理念的远程家庭康复指导。出院前后采用蒙特利尔认知评估量表（MoCA）、综合医院焦虑/抑郁情绪测定表（HADs）、社会活动功能问卷（FAQ）对患者进行评定，并记录事件相关电位P300潜伏期和波幅。结果：出院后第1个月、3个月观察组患者MoCA评分均明显高于出院前（均P<0.01），且同时间点组间比较，观察组MoCA评分均更高于对照组（均P<0.05）；出院后3个月，2组患者MoCA评分较出院后1个月均明显提高（均P<0.01）。出院后第1个月、3个月观察组患者HAD-A和HAD-D评分均明显低于出院前（均P<0.01），出院后3个月，2组患者HAD-A、HAD-D及FAQ评分较出院后1个月比较均明显降低（均P<0.01）；出院后1个月，观察组FAQ评分明显低于对照组（P<0.05）；出院后3个月，观察组HAD-A、HAD-D及FAQ评分均明显低于对照组（均P<0.05）。出院后3个月，2组患者P300潜伏期较出院前明显缩短（均P<0.01），波幅明显增大（均P<0.01），且观察组P300潜伏期较对照组更短（P<0.01），波幅较对照组更大（P<0.05）。结论：基于EE理念的远程家庭康复指导可以改善PSCIND患者认知功能及焦虑抑郁情绪，有利于提高其工具性日常生活能力。 |
| 英文摘要: |
| Objective: To investigate the effects of tele-rehabilitation guidance based on the concept of enriched environment on the cognitive function, psychological and daily living ability in the non-dementia cognitive impairment residential stroke patients. Methods: Totally 68 patients with non-dementiacognitive impairment after stroke were randomly divided into the control group (33 cases) and the treatment group (35 cases) by using the random number table. The control group was given routine rehabilitation education before discharge and regular outpatient rehabilitation, the treatment group was added with tele-rehabilitation guidance based on the concept of enriched environment. Before and after discharge, patients were assessed with Montreal Cognitive Assessment Scale (MoCA), General Hospital Anxiety/Depression Scale (HADs) and Social Activity Function Questionnaire (FAQ), and the latency and amplitude of event-related potential P300 were recorded.Results: The MoCA scores of patients in the treatment group were significantly higher than those before discharge at the first month and the third month after discharge (all P<0.01), and the MoCA scores in the treatment group were higher than those in the control group at the same time point (all P<0.05). Three months after discharge, MoCA scores of patients in both groups were significantly higher than those in one month after discharge (P<0.01). HAD-A and HAD-D scores of patients in the treatment group were significantly lower than those before discharge (all P<0.01) at the first month and the third month after discharge, and HAD-A, HAD-D and FAQ scores of patients in the two groups were significantly lower than those one month after discharge (all P<0.01). One month after discharge, the FAQ score of the treatment group was significantly lower than that of the control group (P<0.05). Three months after discharge, the scores of HAD-A, HAD-D and FAQ in the treatment group were significantly lower than those in the control group (P<0.05). Three months after discharge, the latency and amplitude of P300 in the treatment group were significantly shorter (P<0.01) and larger (P<0.05) than those in the control group. Conclusion:Tele-rehabilitation guidance based on the concept of enriched environment can improve the cognitive function, anxiety and depression of patients with non-dementia cognitive impairment after stroke, and is beneficial to improve their instrumental activity of daily living. |
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