系統(tǒng)性言語(yǔ)康復(fù)訓(xùn)練在腦梗死后運(yùn)動(dòng)性失語(yǔ)中的應(yīng)用

韓莉 朱倩倩 陳光

[摘要]目的 探討系統(tǒng)性言語(yǔ)康復(fù)訓(xùn)練在腦梗死后運(yùn)動(dòng)性失語(yǔ)中的應(yīng)用。 方法 選取2015年4月～2017年10月就診的腦梗死后運(yùn)動(dòng)性失語(yǔ)患者76例，隨機(jī)分為干預(yù)組和對(duì)照組，每組38例。兩組均予以降顱壓，控制血壓、血糖和血脂，拮抗血小板聚集和營(yíng)養(yǎng)腦細(xì)胞等基礎(chǔ)治療。對(duì)照組予以常規(guī)干預(yù)措施，干預(yù)組患者在對(duì)照組基礎(chǔ)上采用系統(tǒng)性言語(yǔ)康復(fù)訓(xùn)練，兩組均干預(yù)16周。分別于干預(yù)前及干預(yù)16周后比較并評(píng)估兩組語(yǔ)言能力的變化情況，并比較臨床效果。 結(jié)果 干預(yù)16周后，兩組語(yǔ)言功能各項(xiàng)評(píng)分較干預(yù)前改善（P<0.05或P<0.01）;且治療后干預(yù)組改善幅度比對(duì)照組更明顯（P<0.05）;同時(shí)干預(yù)組臨床總有效率（94.74%）較對(duì)照組（78.95%）更佳（χ2=4.15，P<0.05）。 結(jié)論 系統(tǒng)性言語(yǔ)康復(fù)訓(xùn)練在腦梗死后運(yùn)動(dòng)性失語(yǔ)中的應(yīng)用效果較肯定，能顯著提高患者語(yǔ)言能力。

[關(guān)鍵詞] 腦梗死;運(yùn)動(dòng)性失語(yǔ);系統(tǒng)性言語(yǔ)康復(fù)訓(xùn)練;語(yǔ)言功能

[中圖分類號(hào)] R743.33;R473.74? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] B? ? ? ? ? [文章編號(hào)] 1673-9701（2020）04-0080-04

Application of systematic speech rehabilitation training in motor aphasia after cerebral infarction

HAN Li? ?ZHU Qianqian? ?CHEN Guang

Department of Neurology， Taizhou Hospital of Zhejiang Province， Linhai? ?317000， China

[Abstract] Objective To explore the application of systemic speech rehabilitation training in motor aphasia after cerebral infarction. Methods 76 patients with post-cerebral infarction motor aphasia were selected from April 2015 to October 2017， and were randomly divided into intervention group and control group， with 38 cases in each group. Both groups were treated with basic treatment， including lowering intracranial pressure， controlling blood pressure， blood sugar and blood lipids， antagonizing platelet aggregation and nurturing brain cells. The control group was given routine interventions. The intervention group was given systemic speech rehabilitation training. Both groups were treated for 16 weeks. The changes in language ability between the two groups were compared and evaluated before intervention and 16 weeks after intervention， and the clinical effects were compared. Results After 16 weeks of intervention， the scores of language function of the two groups were improved compared with those before intervention（P<0.05 or P<0.01）; and the improvement of the intervention group was more obvious than that of the control group （P<0.05）. The total clinical effective rate was higher in the intervention group （94.74%） than in the control group （78.95%） （χ2=4.15， P<0.05）. Conclusion Systemic speech rehabilitation training has a significant effect on motor aphasia after cerebral infarction， which can significantly improve the language ability of patients.

[Key words] Cerebral infarction; Motor aphasia; Systemic speech rehabilitation training; Language function

運(yùn)動(dòng)性失語(yǔ)是腦梗死后較常見(jiàn)的并發(fā)癥和后遺癥之一，以口語(yǔ)表達(dá)障礙最為突出，發(fā)病率為10%～25%，影響患者的日常工作和正常生活，使患者生活質(zhì)量下降[1，2]。以往對(duì)腦梗死的康復(fù)訓(xùn)練以神經(jīng)康復(fù)及肢體功能鍛煉為主，而對(duì)語(yǔ)言功能康復(fù)的鍛煉臨床上往往重視不夠[3，4]。系統(tǒng)性言語(yǔ)康復(fù)訓(xùn)練是指對(duì)后天獲得的言語(yǔ)功能障礙采用一系列康復(fù)訓(xùn)練方法用于治療腦梗死后運(yùn)動(dòng)性失語(yǔ)，國(guó)內(nèi)外報(bào)道較少[5，6]。本研究分析系統(tǒng)性言語(yǔ)康復(fù)訓(xùn)練在腦梗死后運(yùn)動(dòng)性失語(yǔ)中的應(yīng)用，現(xiàn)報(bào)道如下。

1 資料與方法

1.1 一般資料

選取2015年4月～2017年10月在我院內(nèi)科門診就診的腦梗死后運(yùn)動(dòng)性失語(yǔ)患者76例。納入標(biāo)準(zhǔn)[7]：①符合《中國(guó)急性缺血性腦卒中診治指南》制定的標(biāo)準(zhǔn)[8]，經(jīng)頭顱CT/MRI檢查證實(shí);②符合《漢語(yǔ)失語(yǔ)癥檢查法》中運(yùn)動(dòng)性失語(yǔ)的診斷標(biāo)準(zhǔn)[9]。……