以听觉失认为首发症状的脑卒中康复4例报道

doi:10.3969/j.issn.1006-9771.2020.07.022

摘要/Abstract

摘要：

目的分析卒中后听觉失认的临床特点、诊治和康复。方法回顾性分析2016年1月至2018年8月4例以听觉失认为首发症状的脑卒中住院患者。结果 4例患者均以听觉障碍起病,并发肢体运动功能障碍、言语障碍等,既往有一次或多次脑血管病史,检查后确诊为卒中后听觉失认。经综合康复,所有患者运动功能恢复良好,可独立步行,日常生活活动能力改善,部分患者环境音辨别改善,但言语听理解能力改善不明显。结论卒中后听觉失认临床少见,预后不良,应全面评估,有针对性地行言语感知训练,并加强非语言交流方式训练,提高交流实用性。

关键词: 脑卒中, 听觉失认, 皮质聋, 听觉空间忽略

Abstract:

Objective To study the clinical characteristics, diagnosis, treatment and rehabilitation of auditory agnosia after stroke.Methods Four stroke inpatients with auditory agnosia as the first symptom from January, 2016 to August, 2018 were reviewed. Results All the patients started with auditory impairment, followed with motor dysfunction and speech impairment. They had a previous history of cerebrovascular disease once or more, and were finally diagnosed as auditory agnosia after stroke. After comprehensive rehabilitation treatment, all the patients could walk independently, and the activities of daily living were improved. Some patients could discriminate environmental sound, but still were poor in listening comprehension. Conclusion Post-stroke auditory agnosia is rare, with poor outcome, which needs comprehensive assessment, speech perception training and non-verbal communication training to improve the communication.

Key words: stroke, auditory agnosia, cortical deafness, auditory neglect

中图分类号:

R743.3

刘平,胡雪艳,何静杰. 以听觉失认为首发症状的脑卒中康复4例报道[J]. 《中国康复理论与实践》, 2020, 26(7): 851-855.

LIU Ping,HU Xue-yan,HE Jing-jie. Rehabilitation for Stroke with Auditory Agnosia as the First Symptom: Four Cases Report[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(7): 851-855.

图/表 3

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时间	Fugl-Meyer评定量表	Holden步行分级	改良Barthel指数
治疗前	24(20~35)	0~1级	25(20~35)
治疗后	87(84~92)	3~4级	80(75~85)

时间	听理解、复述、听写	表达、阅读、书写
治疗前	0	90
治疗后	0	100