Chinese Journal of Stroke ›› 2021, Vol. 16 ›› Issue (11): 1144-1149.DOI: 10.3969/j.issn.1673-5765.2021.11.010

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Application of Personalized Cognitive Function Nursing and Training in Adult Patients with Moyamoya Diseaseafter Surgical Revascularization

  

  • Received:2021-06-09 Online:2021-11-20 Published:2021-11-20

个性化脑认知功能护理与训练在成人烟雾病手术患者中的应用研究

赵东红, 张东, 薛锐, 袁巧玲   

  1. 北京 100070首都医科大学附属北京天坛医院神经外科
  • 通讯作者: 袁巧玲 lqyuan1969@sina.com
  • 基金资助:
    北京市医院管理局“登峰”人才培养计划(DFL20180501)

Abstract: Objective To explore the effect of personalized cognitive function nursing and training in cognitive function recovery of adult patients with Moyamoya disease (MMD) who received surgical revascularization. Methods This study prospectively enrolled the adult MMD patients who underwent surgical revascularization in Beijing Tiantan Hospital between November 2018 and July 2020. All the patients were randomly divided into observation group and control group. The routine care were given in control group; and individualized cognitive function nursing and training based on routine nursing were given in observation group. The cognition scores of preoperative and postoperative 3-months between the two groups were compared, including Adult Webster’s Intelligence Scale (WAIS), the Chinese version of the Cambridge Prospective Memory Test (CAMPROMPT) and the Repeatable Battery of Neuropsychological State (RBANS) [including immediate memory(IM) and delayed memory (DM)].The ischemic and hemorrhagic events and prognosis were compared between the two group during the 3-month follow-up. The prognosis was evaluated by mRS, with

a score of 0-1 for normal neurological function, 2-3 for mild disability, and 4-5 points for severe

disability. Results A total of 140 adult patients with MMD were included, including 70 cases in control group and 70 cases in observation group. There were no statistical differences in baseline data and preoperative cognitive function score between the two groups. No significant difference in WAIS score (observation vs control: 98.11±11.16 points vs 95.27±14.83 points) was observed (P >0.05) between the two groups. The scores of CAMPROMPT (22.99±4.11 points vs 20.41±5.69 points, P =0.003), RBANS-DM (89.86±18.96 points vs 79.54±16.12 points, P =0.001) and RBANS-IM (84.43±12.35 points vs 79.61±15.93 points, P =0.048) were higher in observation group than those in control group. Conclusions The application of personalized cognitive function nursing and training in adult MMD patients after surgical revascularization was an important treatment method for promoting cognitive function recovery, especially for memory.

Key words: Personalized cognitive function training; Moyamoya disease; Cerebral revascularization; Outcome; Cognitive function; Memory

摘要: 目的 探讨个性化脑认知功能护理与训练在成人烟雾病脑血运重建手术患者中的应用效果。 方法 连续前瞻性入组2018年11月-2020年7月首都医科大学附属北京天坛医院行脑血运重建手 术治疗的成人烟雾病患者,随机分为对照组和研究组。对照组住院期间给予常规护理;研究组在 常规护理的基础上进行个性化脑认知功能护理与训练。比较两组术前和随访3个月时的成人韦氏 智力量表(Wechsler adult intelligence scale,WAIS)、中文版剑桥前瞻性记忆测试(Chinese version of the Cambridge prospective memory test,CAMPROMPT)和重复性成套神经心理状态测验(repeatable battery of neuropsychological state,RBANS)中的中的即刻记忆(immediate memory,IM)分项和延迟记 忆(delayed memory,DM)分项得分。比较两组术后3个月缺血性和出血性卒中复发率和预后(mRS 0~1分为神经功能正常,2~3分为轻度残疾,4~5分为重度残疾)。 结果 研究共入组14 0例患者,对照组和研究组各70例,两组基线资料和术前认知功能评 分差异均无统计学意义。3个月随访时,研究组与对照组WAI S差异无统计学意义(98.11±11.16 分 vs 95.27±14.83分,P =0.202);研究组的CAMPROMPT评分(22.99±4.11分 vs 20.41±5.69分, P =0.003)、RBANS-DM(89.86±18.96分 vs 79.54±16.12分,P =0.001)、RBANS-I M(84.43±12.35 分 vs 79.61±15.93分,P =0.048)评分均高于对照组。 结论 对成人烟雾病脑血运重建手术治疗的患者实施个性化脑认知功能护理与训练,有利于患者 认知功能,特别是记忆力的康复。

关键词: 个性化脑认知功能训练; 烟雾病; 脑血运重建手术; 预后; 认知功能; 记忆力