脑器质性精神障碍患者认知功能障碍研究

摘要

目的：探讨脑出血所导致的脑器质性精神障碍患者认知功能障碍的影响因素。方法收集首发脑出血患者84例、再发脑出血患者90例和正常对照68例资料，记录患者一般资料、出血部位、出血量，并通过简易智能精神状态检查量表（MMSE）测评认知功能障碍。结果脑梗死组认知功能障碍发生率显著高于正常对照组（ P <0.01），而再发脑出血组也比首发脑出血组更易导致认知功能障碍（ P <0.01）。高龄、高血糖、高血脂、高血压均属于脑出血患者认知功能障碍的危险因素（ P <0.05）；左大脑半球出血比右大脑半球出血更易导致认知功能障碍（ P <0.05），脑叶出血会引起认知功能障碍发生率更高（ P <0.05）；脑出血患者记忆力、回忆力和注意力衰退明显（ P <0.01）。结论监控脑出血患者认知功能障碍的危险因素，着重注意患者记忆力、回忆力及注意力的康复训练，将对脑出血患者认知功能障碍的预防和康复提供很大帮助。%Objective To explore the influencing factors of cognitive dysfunction in patients with brain organic mental disorder caused by cerebral hemorrhage in order to provide some help for clinical prevention and rehabilitation therapy. Methods We collected 84 cases of primary cerebral hemorrhage,90 cases of recurrent cerebral hemorrhage,and 68 normal cases in the present study. To record the general information, bleeding site,as well as bleeding volume of patients,and evaluate the cognitive dysfunction of the patients through minimum mental state examina-tion scale(MMSE). Results The incidence of cognitive dysfunction in the cerebral infarction group was significantly higher than that in the con-trol group( P < 0. 01),while the recurrent intracerebral hemorrhage group was more likely to lead to cognitive dysfunction( P < 0. 01)than the first episode of intracerebral hemorrhage. Age,high blood sugar,high blood fat,high blood pressure were the risk factors of cognitive dysfunction in patients with cerebral hemorrhage( P < 0. 05). The left cerebral hemorrhage was more likely to suffer cognitive dysfunction than right cerebral hemisphere( P < 0. 05). Lobar hemorrhage could increase cognitive dysfunction rate( P < 0. 05). Memory and attention in patients with intrac-erebral hemorrhage declined significantly( P < 0. 01). Conclusion Monitoring the risk factors of cognitive impairment in patients with intracere-bral hemorrhage was very important. We should pay attention to the recovery of patients′ memory. Memory force and attention will provide great help to prevent and rehabilitate cognitive dysfunction in patients with cerebral hemorrhage.