认知-语言双任务训练措施在老年脑出血恢复期的应用研究

doi:10.3760/cma.j.cn441417-20250427-16014

摘要/Abstract

摘要：

目的　探讨认知-语言双任务训练措施在老年脑出血恢复期患者中的应用效果。方法　采用前瞻性研究，选取空军军医大学第二附属医院2023年2月至2024年10月接诊的162例老年脑出血恢复期患者，随机数字表法分为观察组82例、对照组80例。观察组男55例、女27例，年龄（67.29±5.52）岁，病程（1.54±0.39）月；对照组男51例、女29例，年龄（66.81±5.35）岁，病程（1.58±0.25）月。对照组采用常规训练方式，观察组采用认知-语言双任务训练方案，均持续干预3个月。比较两组干预前与干预1个月、3个月后的简易智力状态评估检查量表（MMSE）、蒙特利尔认知评估量表（MoCA）、汉语标准失语症检查（CRRCAE）量表、日常生活交流能力量表（CADL）评分及神经生长因子（NGF）、神经元特异性烯醇化酶（NSE）、脑源性神经营养因子（BDNF）的变化与患者满意度，采用重复测量方程分析、χ²检验、t检验进行统计比较。结果　干预1个月、3个月后，观察组MMSE、MoCA、CRRCAE与CADL评分均高于对照组［（26.32±1.47）分比（25.57±1.55）分、（25.51±1.38）分比（24.74±2.12）分、（69.21±6.03）分比（66.67±6.91）分、（77.53±5.26）分比（74.87±4.93）分、（27.74±1.05）分比（27.15±1.18）分、（27.39±1.14）分比（26.89±1.06）分、（76.84±6.53）分比（73.69±7.45）分、（86.63±5.81）分比（84.39±5.64）分］，差异均有统计学意义（均P<0.05）。干预1个月后，观察组NGF、BDNF高于对照组［（365.38±25.61）ng/L比（355.31±21.04）ng/L、（7.55±1.84）μg/L比（6.81±1.60）μg/L］，NSE低于对照组［（10.54±2.10）μg/L比（11.68±2.33）］μg/L；干预3个月后，观察组NGF、BDNF高于对照组［（472.31±32.64）ng/L比（454.04±38.48）ng/L，（8.93±1.65）μg/L比（8.22±1.73）μg/L］，NSE低于对照组［（8.52±1.39）μg/L比（9.15±1.61）μg/L］；差异均有统计学意义（均P<0.05）。观察组对训练的总满意度高于对照组［91.46%（75/82）比80.00%（64/80）］，差异有统计学意义（P<0.05）。结论　认知-语言双任务训练措施有助于促进老年脑出血恢复期患者认知、语言功能恢复，提高患者满意度。

关键词:

老年, 脑出血, 恢复期, 认知训练, 语言训练, 神经因子

Abstract:

Objective　To explore the effect of cognitive-language dual-task training measures for elderly patients in the recovery period of cerebral hemorrhage. Methods　One hundred and sixty-two elderly patients in the recovery period of cerebral hemorrhage admitted to the Second Affiliated Hospital of Air Force Military Medical University from February 2023 to October 2024 were selected for the randomized controlled trial, and were divided into an observation group (82 cases) and a control group (80 cases) by the random number table method. In the observation group, there were 55 males and 27 females, with an age of (67.29±5.52) years, and a disease duration of (1.54±0.39) months. In the control group, there were 51 males and 29 females, with an age of (66.81±5.35) years, and a disease duration of (1.58±0.25) months. The control group took conventional training, while the observation group adopted the cognitive-language dual-task training program, for 3 months. The scores of Mini-Mental State Assessment Scale (MMSE), Montreal Cognitive Assessment Scale (MoCA), Chinese Standard Aphasia Test (CRRCAE) scale, and Activity of Daily Living Communication Scale (CADL) and levels of nerve growth factor (NGF), neuron-specific enolase (NSE), and brain-derived neurotrophic factor (BDNF) before and 1 and 3 months after the intervention, as well as the patients' satisfaction, were compared between the two groups. The repeated measures equation analysis, χ² test and t test were used for the statistical comparisons. Results　After 1 and 3 months' intervention, the scores of MMSE, MoCA, CRRCAE, and CADL in the observation group were higher than those in the control group (26.32±1.47 vs. 25.57±1.55, 25.51±1.38 vs. 24.74±2.12, 69.21±6.03 vs. 66.67±6.91, 77.53±5.26 vs. 74.87±4.93, 27.74±1.05 vs. 27.15±1.18, 27.39±1.14 vs. 26.89±1.06, 76.84±6.53 vs. 73.69±7.45, and 86.63±5.81 vs. 84.39±5.64), with statistical differences (all P<0.05). After 1 months' intervention, the levels of NGF and BDNF in the observation group were higher than those in the control group [(365.38±25.61) ng/L vs. (355.31±21.04) ng/L and (7.55±1.84) μg/L vs. (6.81±1.60) μg/L], and the level of NSE was lower [(10.54±2.10) μg/L vs. (11.68±2.33)] μg/L; after 3 months' intervention, the levels of NGF and BDNF in the observation group were higher than those in the control group [(472.31±32.64) ng/L vs. (454.04±38.48) ng/L and (8.93±1.65) μg/L vs. (8.22±1.73) μg/L], and the level of NSE was lower [(8.52±1.39) μg/L vs. (9.15±1.61) μg/L]; there were statistical differences (all P<0.05). The total satisfaction of the observation group with the training was higher than that of the control group [91.46% (75/82) vs. 80.00% (64/80)], with a statistical difference (P<0.05). Conclusion　Cognitive-language dual-task training measures for elderly patients in the recovery period of cerebral hemorrhage can promote their recovery of cognitive and language functions and improve their satisfaction.

Key words:

Elderly, Cerebral hemorrhage, Recovery period, Cognitive training, Language training, Nerve factors

李凤侠张洁王志江李亚琴程诗晴蔡丽.

认知-语言双任务训练措施在老年脑出血恢复期的应用研究 [J]. 国际医药卫生导报, 2025, 31(16): 2709-2714.

Li Fengxia, Zhang Jie, Wang Zhijiang, Li Yaqin, Cheng Shiqing, Cai Li.

Application of cognitive-language dual-task training measures in recovery period of elderly patients with cerebral hemorrhage [J]. International Medicine and Health Guidance News, 2025, 31(16): 2709-2714.

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