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目的:对脑梗死合并不同程度记忆障碍患者进行康复训练,探讨不同康复训练的疗效。方法:选择早期脑梗死合并记忆功能障碍的患者共219例,根据Rivermead行为记忆测验第2版(RMBT-Ⅱ)评估结果将其分为轻、中、重度,将每一程度记忆功能障碍的患者随机分为对照组、干预1组、干预2组。对照组给予常规康复治疗;干预1组在常规康复的基础上给予面对面个体化训练;干预2组在常规康复的基础上给予电脑互动游戏。在干预6周、干预12周、干预结束后4周多次进行记忆功能评估,比较记忆功能的差异。结果:脑梗死合并轻中度记忆障碍患者,与对照组比较,在干预6周时,干预1组记忆分数明显升高;在干预12周时,干预1组、干预2组记忆分数均有明显升高;在干预结束后4周,干预1组记忆分数有明显升高,差异有统计学意义(P<0.05)。与干预2组比较,干预1组在干预6周、干预12周、干预结束后4周记忆分数均有明显升高,差异有统计学意义(均P<0.05)。脑梗死合并重度记忆障碍患者,各组间、各时间点记忆分数均未有明显变化(P>0.05)。结论:对于脑梗死合并轻中度记忆障碍的患者,面对面个体化训练对提高记忆有效,电脑互动游戏可能有效,且面对面个体化训练起效更快,中断记忆训练后,维持记忆的时间也更长。对于脑梗死合并重度记忆障碍的患者,面对面个体化训练和体感互动游戏疗效均不明显。
Objective: To carry out rehabilitation training on cerebral infarction patients with different degree of memory impairment and to explore the effect of different rehabilitation training. Methods: A total of 219 patients with early cerebral infarction complicated with memory dysfunction were selected and divided into mild, moderate and severe according to the second edition of the Rivermead behavioral memory test (RMBT-Ⅱ). All patients with memory dysfunction Randomly divided into control group, intervention group 1, intervention group 2. The control group was given routine rehabilitation. Intervention group 1 received face-to-face individual training on the basis of routine rehabilitation. Intervention group 2 was given computer interactive games on the basis of routine rehabilitation. After 6 weeks of intervention and 12 weeks of intervention, memory function evaluation was repeated several times 4 weeks after the intervention, and the difference of memory function was compared. Results: Compared with the control group, the scores of memory in intervention group 1 were significantly increased at 6 weeks after intervention. In the intervention group at 12 weeks, the memory scores of intervention group 1 and 2 were significantly higher 4 weeks after the intervention, the memory scores of the intervention group 1 were significantly increased, the difference was statistically significant (P <0.05). Compared with the intervention group 2, the intervention group 1 had a significant increase in memory scores 6 weeks after intervention, 12 weeks after intervention and 4 weeks after intervention (all P <0.05). In patients with severe cerebral infarction and severe memory impairment, there was no significant change in the memory scores between the groups at all time points (P> 0.05). CONCLUSIONS: Face-to-face individual training is effective for improving memory in patients with cerebral infarction complicated with mild to moderate memory impairment. Computer interactive games may be effective, and face-to-face individualized training works faster, and memory training breaks the memory time long. For patients with cerebral infarction complicated with severe memory impairment, face-to-face individual training and somatosensory interactive game efficacy are not obvious.