急性缺血性脑卒中患者心理、情绪和认知障碍的诊断

A. M. Tynterova
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摘要

目的:评估急性缺血性脑卒中后左右脑半球病变患者认知、心理、情绪、行为障碍的严重程度、自我控制水平及某些应对策略的患病率。材料与方法:本研究纳入60例诊断为缺血性脑卒中的患者。根据中风的部位,将患者分为两组:1 - 30例右半球病变患者,2 - 30例左半球病变患者。研究于治疗第7天进行,包括:根据蒙特利尔量表评估认知状态(并附有评估右半球功能的额外量表);使用四维症状问卷评估苦恼、抑郁、焦虑和躯体化水平;采用MFI-20量表评估身心乏力,采用Rotter控制源量表评估自我控制水平,采用E. Heim应对问卷评估应对策略模式。结果:本研究确定了右半球损伤患者的抑郁患病率、非适应性应对策略倾向、概念实践相关的隐喻理解障碍和低自控水平与健康的关系。局部左半球缺血性脑卒中患者的特点是高度的精神衰弱,选择适应性和相对适应性的应对策略,在人际关系方面自我控制水平较低。结论:本研究结果表明,脑卒中急性期左右脑半球病变患者的神经精神症状存在定性和定量差异。抑郁症、认知障碍和非适应性应对策略在右半球损伤患者中占主导地位,即使有轻微或中度的运动缺陷,也需要对患者的行为、神经精神和认知综合征进行早期检查。研究结果表明,在急性中风期间,有必要为左右脑半球损伤的患者制定个性化的心理康复计划。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnostic of psychoemotional and cognitive impairments in acute ischemic stroke
Aims: to assess the severity of cognitive, psychoemotional, behavioral disorders, the level of self-control and prevalence of certain coping strategies in patients with lesions of the right and left cerebral hemispheres after acute ischemic stroke. Materials and methods: The study included 60 patients with a diagnosis of ischemic stroke. Depending on the location of the stroke, patients were divided into two groups: Group 1 - 30 patients with lesions of the right hemisphere, Group 2 - 30 patients with lesions of the left hemisphere. The study was conducted on the 7th day of treatment and included: assessment of the cognitive status according to the Montreal scale (with additional scales for assessing the functions of the right hemisphere); assessment of the level of distress, depression, anxiety and somatization using the Four DimensionalSymptomQuestionnaire; assessment of mental and physical asthenia according to the MFI-20 scale, level of self-control using the Rotter'sLocus of Control Scale and coping strategies modality using E. Heim coping questionnaire. Results: The study established the prevalence of depression, a tendency towards non-adaptive coping strategies, ideational praxis related disorders understanding of metaphors and low level of self-control in relation to health in patients with lesions of the right hemisphere. Patients with ischemic stroke localized in the left hemisphere are characterized by a high level of mental asthenia, a choice of adaptive and relatively adaptive coping strategies, and a low level of self-control in respect to interpersonal relationships. Conclusions: The results of the study show that in the acute period of stroke there are qualitative and quantitative differences in neuropsychiatric symptoms of patients with lesions of the right and left cerebral hemispheres. The predominance of depression, cognitive impairments, and non-adaptive coping strategies in patients with lesions of the right hemisphere even with minimal or moderate motor deficits justifies early examination of the patient's behavioral, neuropsychiatric, and cognitive syndromes. The results of the study indicate the need to develop individual psychological rehabilitation programs for patients with lesions of the right and left cerebral hemispheres during the acute period of stroke.
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