《中国康复理论与实践》

《中国康复理论与实践》

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脑损伤患者的执行功能损害①

张慧丽，恽晓平，郭华珍，宋桂芸，高明明   

  1. 1.首都医科大学康复医学院，北京市100068；2.中国康复研究中心北京博爱医院康复评定科，北京市100068。
  • 出版日期:2016-05-25 发布日期:2016-07-04

Executive Function Deficits in Patients with Brain Injury

ZHANG Hui-li, YUN Xiao-ping, GUO Hua-zhen, SONG Gui-yun, GAO Ming-ming   

  1. 1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China; 2. Department of Rehabilitation Evaluation, Beijing Bo'ai Hospital, China Rehabilitation Research Centre, Beijing 100068, China
  • Published:2016-05-25 Online:2016-07-04

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摘要： 目的探索脑损伤患者执行功能损害特征。方法2015 年3 月1 日~6 月30 日，选择44 例脑损伤患者进行威斯康星卡片分类测验，包括总应答数、完成分类数、正确应答数、错误应答数、首次分类应答数、概括水平、持续性错误数、非持续性错误数、规则坚持失败、学习到学会。结果非持续性错误数和概括水平异常率最高(61.36%)，以下依次是总应答数、完成分类数、错误应答数(59.09%)，正确应答数(43.18%)，首次分类应答数(38.64%)，持续性错误数(29.51%)，学习到学会(25.00%)，规则坚持失败(9.09%)。脑卒中患者与脑外伤患者在总应答数、完成分类数、错误应答数、概括水平、持续性错误数、学习到学会方面有显著性差异(Z>2.444, t>2.156, P<0.05)。与非额叶损伤患者比较，额叶损伤患者持续性错误数较多(t=2.595, P=0.015)。结论脑损伤患者执行功能普遍受损，涉及注意集中、抽象概括、注意转移、工作记忆。额叶损伤主要影响注意转移。

关键词: 脑损伤, 执行功能, 威斯康星卡片分类测验

Abstract: Objective To investigate the characteristics of executive function in patients with brain injury. Methods From March 1st, to June 30th, 2015, 44 patients with brain injury were investigated with Wisconsin Card Sorting Test (WCST), the indexes including Responses Answer, Categories Completed, Correct Responses, Errors Responses, Trials to Complete First Category, Percent Conceptual Level Responses Percentage, Perseverative Responses Errors, Nonperseverative Responses Errors, Failure to Maintain Set, and Learning to Learn. Results The abnormal rates were the most in Nonperseverative Responses Errors and Percent Conceptual Level Responses Percentage (61.36%), and then in Responses Answer/Categories Completed/Correct Responses (59.09%), Correct Responses (43.18%), Trials to Complete First Category (38.64%), Perseverative Errors (29.51%), Learning to Learn (25.00%), and Failure to Maintain Set (9.09%). The patients with traumatic brain injury were different from those with stroke in Responses Answer, Errors Responses, Perseverative Responses Errors, Categories Completed, Percent Conceptual Level Responses Percentage, and Learning to Learn (Z>2.444, t>2.156, P<0.05). The patients injured in frontal lobe were different from those in other areas in Perseverative Responses Errors (t=2.595, P=0.015). Conclusion Executive function damaged generally in patients with brain injury, which related to concentration, abstract, shifting attention, working memory, etc. The frontal lobe damage may associate with the disorder of shifting attention

Key words: brain injury, executive function;Wisconsin Card Sorting Test