本文關鍵詞： 血管性認知障礙 愉快家庭康復 認知訓練　出處：《河北大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的血管性認知障礙(vascular cognitive impairment,VCI)是指由血管因素參與或?qū)е碌恼J知功能障礙,可單獨發(fā)生或與阿爾茨海默病(Alzheimer disease,AD)伴發(fā),是一類慢性進行性疾病,涵蓋了從輕度認知障礙到癡呆的全部過程。愉快家庭康復治療是以愉快因子為前提、以家庭為單位、以認知康復訓練為主要內(nèi)容的康復治療方法。本研究探討愉快家庭康復治療對血管性認知障礙患者的認知功能及日常生活能力的改善情況,并評價其療效,從而為血管性認知障礙患者提供方便、實用、有效的康復方法。方法選取2015年04月至2016年04月在河北大學附屬醫(yī)院神經(jīng)內(nèi)科門診就診及神經(jīng)內(nèi)科病房住院治療的90例確診的血管性認知障礙患者為研究對象,嚴格執(zhí)行納入標準及排除標準。對所有入組患者按照隨機數(shù)字表隨機分為愉快家庭康復組(A組)和對照組(B組),每組45例。實際完成整個康復療程的患者共80例,其中愉快家庭康復組(A組)為40例,對照組(B組)為40例。血管性認知障礙診斷均符合2011年血管性認知功能障礙診治指南標準。兩組患者均給予常規(guī)口服藥物治療和常規(guī)運動功能康復訓練,在此治療基礎上,愉快家庭康復組添加愉快家庭康復治療。兩組患者均于治療開始時及治療12周后進行蒙特利爾認知評估量表(Montreal cognitive assessment,MoCA)和日常生活能力量表(Activities of Daily Living,ADL)評分,通過對比統(tǒng)計分析兩組的MoCA、ADL評分,從而評價兩組患者認知功能及日常生活能力的改善情況。結(jié)果1.治療前后MoCA評分的比較(1)愉快家庭康復組(A組)及對照組(B組)同一組內(nèi)比較:治療后MoCA評分均較治療前有所提高(tA=15.637,P=0.000;tB=5.994,P=0.000),說明兩組治療均可提高MoCA評分,可有效改善患者認知功能。(2)愉快家庭康復組(A組)與對照組(B組)組間比較:治療12周后,兩組評分分別為20.95±1.358、18.1±1.837,愉快家庭康復組評分高于對照組,差異具有統(tǒng)計學意義(t=7.891,P=0.000),說明愉快家庭康復組較對照組改善患者認知功能療效顯著。2.治療前后ADL評分的比較(1)愉快家庭康復組(A組)及對照組(B組)同一組內(nèi)比較:治療后ADL評分均較治療前有所提高(tA=15.109,P=0.000;tB=11.195,P=0.000),說明兩組治療均可增加ADL評分,有效提高患者日常生活能力。(2)愉快家庭康復組與對照組組間比較:治療12周后,兩組評分分別為68.30±2.747、65.50±3.030,愉快家庭組評分高于對照組,差異具有統(tǒng)計學意義(t=4.330,P=0.000),說明愉快家庭康復組提高患者日常生活能力療效好于對照組。結(jié)論愉快家庭康復治療可有效改善血管性認知障礙患者的認知功能,同時明顯提高其日常生活能力,為血管性認知障礙患者的康復治療提供新思路。
[Abstract]:Objective: vascular cognitive impairment (VCI) refers to the cognitive dysfunction caused by vascular factors, which can occur alone or with Alzheimer's disease. It is a kind of chronic progressive disease. It covers the whole process from mild cognitive impairment to dementia. This study was designed to explore the improvement of cognitive function and daily life ability of vascular cognitive impairment patients after the treatment of pleasant family rehabilitation, and to evaluate the efficacy of the treatment. Thus providing convenience and practicality for patients with vascular cognitive impairment, Methods from April 2015 to April 2016, 90 patients with vascular cognitive impairment were selected from the Department of Neurology, Department of Neurology, affiliated Hospital of Hebei University and hospitalized in the Department of Neurology, Hebei University. According to the random digital table, all the patients were randomly divided into two groups: group A (group A) and group B (group B), with 45 cases in each group. There were 80 patients who had actually completed the whole course of rehabilitation. There were 40 cases in the happy family rehabilitation group (group A). The diagnosis of vascular cognitive impairment was in accordance with the guidelines for the diagnosis and treatment of vascular cognitive dysfunction in 2011. Both patients in both groups were given routine oral drug therapy and routine motor rehabilitation training. The patients in the happy family rehabilitation group were given Montreal cognitive assessment scale and activities of Daily living (ADL) scale at the beginning of treatment and 12 weeks after treatment. The scores of MoCAN ADL in the two groups were compared and analyzed. The improvement of cognitive function and ADL in the two groups were evaluated. Results 1. Comparison of MoCA scores before and after treatment (1) comparison of MoCA scores between group A (group A) and group B (control group): MoCA scores after treatment. Compared with before treatment, the MoCA score of the two groups was increased by 15.637 渭 g / L, 0.000 ~ 5.994g / L, indicating that the MoCA score could be improved in both groups, and there was no significant difference between the two groups. After 12 weeks of treatment, the scores of the two groups were 20.95 鹵1.358 鹵18.1 鹵1.837, respectively. The score of the happy family rehabilitation group was higher than that of the control group. The difference was statistically significant, indicating that the cognitive function of the patients in the happy family rehabilitation group was significantly improved than that in the control group .2.Compared with the ADL score before and after treatment, there were 1) A) and B) comparison between the happy family rehabilitation group and the control group (B). The ADL scores after treatment were higher than those before treatment, indicating that the ADL score could be increased in both groups. After 12 weeks of treatment, the scores of the two groups were 68.30 鹵2.747 and 65.50 鹵3.030, respectively. The score of the happy family group was higher than that of the control group. The difference was statistically significant (P < 0.05), which indicated that the effect of improving the ability of daily life of patients in the happy family rehabilitation group was better than that in the control group. Conclusion the treatment of pleasant family rehabilitation can effectively improve the cognitive function of the patients with vascular cognitive impairment. At the same time, improve their ability of daily life, and provide a new idea for rehabilitation of patients with vascular cognitive impairment.
【學位授予單位】：河北大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R749.1

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