轻、中度颅脑创伤后认知障碍的临床研究

摘要

Objective To study the relationship between clinical intervention and prognosis of cognitive impairment in the patients at different periods after mild or moderate traumatic brain injury. Methods Retrospective analysis was conducted to 180 patients with mild or moderate traumatic brain injury and cognitive impairment. They were randomly divided into treatment group A, treatment group B and control group. The treatment group A received donepezil hydrochloride, the treatment group B huperzine A, while the control group piracetam. The treatment cycle was 12 weeks. The Mini Mental Status Examination (MMSE), Wisconsin Card Sorting Test (WCST) and Glasgow Coma Scale (GOS) were employed to evaluate the efficacy before treatment, immediately after treatment, and 3 months after treatment. Results After 12 weeks, the MMSE and WCST scores were improved. The MMSE and WCST scores were better in the treatment group than in the control group. The GOS prognosis was better in the treatment group A than in the treatment group B. Three months after the treatment, the MMSE, WCST scores and GOS prognosis showed significant differences between the 3 groups. The treatment group A got the best efficacy. Conclusion The donepezil hydrochloride can significantly improve cognitive impairment and have effect on the long - term prognosis in the patient with mild or moderate traumatic brain injury.%目的 轻、中度颅脑创伤患者伤后不同时段认知障碍,临床干预以及预后的关系.方法 回顾分析入院治疗的轻重度颅脑创伤合并认知障碍患者180例,依照所用药物分成治疗组A、治疗组B和对照组,治疗组A应用盐酸多奈哌齐,治疗组B应用石杉碱甲,对照组应用吡拉西坦,治疗周期为12周.治疗前及治疗后以及停止治疗3个月分别应用简明精神状态检测量表( MMSE)、威斯康星卡片分类测验系统(WCST)和格拉斯哥预后评分(GOS)评价疗效.结果 治疗12周后MMSE和WCST评分均较治疗前提高.治疗组MMSE和WCST评分提高较对照组明显,治疗组A的GOS预后优良率优于治疗组B.治疗结束3个月后的MMSE和WCCST评分以及GOS预后情况存在显著差异,治疗组A效果最好.结论 盐酸多奈哌齐对轻、中度颅脑创伤后认知障碍有积极治疗作用,对长期预后存在较好效果.