动脉瘤性蛛网膜下腔出血患者术后认知功能长期随访的研究
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摘要
目的探讨动脉瘤性蛛网膜下腔出血患者不同时段认知功能的变化。方法对2015年7月至2017年12月符合纳入标准的122例动脉瘤性蛛网膜下腔出血患者在术前、早期(术后2周)、中期(术后2月)、远期(术后1年)采用简易精神状态量表(MMSE)进行认知功能评价;进行统计学分析。结果术前、早期、中期、远期的MMSE评分分别为:23.30±5.06、20.80±5.68、25.53±3.62、27.79±2.05,F=58.19,P<0.05;认知功能障碍发生率分别为63.11%、80.33%、53.28%、22.95%。结论动脉瘤性蛛网膜下腔出血患者认知功能在不同时段变化,术后早期认知功能障碍最严重,在术后2月恢复到术前水平,在术后1年仍部分存在认知功能障碍,术后2周～1年是认知功能快速恢复阶段。
Objective To investigate the changes of cognitive function in patients with aneurysmal subarachnoid hemorrhage. Methods 122 patients with aneurysmal subarachnoid hemorrhage who met the inclusion criteria from July 2015 to December 2017 were enrolled. Mini-mental state scale(MMSE) were evaluated before operation, early(2 weeks after operation), middle period(2 months after operation) and long term(one year after operation). Results The MMSE scores respectively were 23.30 ±5.06, 20.80 ±5.68, 25.53 ±3.62, 27.79 ±2.05, F =58.19, P <0.05, and the incidence of cognitive dysfunction respectively were 63.11%, 80.33%, 53.28, 22.95%. Conclusion The cognitive function of patients with aneurysmal subarachnoid hemorrhage changed in different time periods, the most serious cognitive dysfunction was in the early postoperative period,and recovered to the preoperative level at 2 months after operation. There was still some cognitive dysfunction in patients one year after operation.From 2 weeks to 1 year after operation, the cognitive function recovered rapidly.
Objective To investigate the changes of cognitive function in patients with aneurysmal subarachnoid hemorrhage. Methods 122 patients with aneurysmal subarachnoid hemorrhage who met the inclusion criteria from July 2015 to December 2017 were enrolled. Mini-mental state scale(MMSE) were evaluated before operation, early(2 weeks after operation), middle period(2 months after operation) and long term(one year after operation). Results The MMSE scores respectively were 23.30 ±5.06, 20.80 ±5.68, 25.53 ±3.62, 27.79 ±2.05, F =58.19, P <0.05, and the incidence of cognitive dysfunction respectively were 63.11%, 80.33%, 53.28, 22.95%. Conclusion The cognitive function of patients with aneurysmal subarachnoid hemorrhage changed in different time periods, the most serious cognitive dysfunction was in the early postoperative period,and recovered to the preoperative level at 2 months after operation. There was still some cognitive dysfunction in patients one year after operation.From 2 weeks to 1 year after operation, the cognitive function recovered rapidly.
引文
1 Zaki Ghali MG,Srinivasan VM,Wagner K,et al.Cognitive sequelae of subarachnoid hemorrhage,cerebral aneurysm treatment,and neuropsychological assessment[J].World Neurosurg.2018,18:394-399.
2 Buunk AM,Spikman JM,Veenstra WS,et al.Social cognition impairments after aneurysmal subarachnoid haemorrhage:Associationswith deficits in interpersonal behaviour,apathy,and impaired selfawareness[J].Neuropsychologia.2017,103:131-139.
3 Su J,E T,Guo Q,et al.Memory Deficits After Aneurysmal Subarachnoid Hemorrhage:A Functional Magnetic Resonance Imaging Study[J].World Neurosurg.2018,111:e500-e506.
4 Ali A,Tanirgan G,Sabanci PA,et al.Relation of gray-white matter ratio with long-term cognitive functions and quality of life in patients with mild to moderate aneurysmal subarachnoid hemorrhage:a prospective observational study[J].Acta Neurochir(Wien).2018,160(1):181-189.
5 T?lli A,H?ybye C,Bellander BM,et,al.The effect of time on cognitive impairments after non-traumatic subarachnoid haemorrhage and after traumatic brain injury[J].Brain Inj.2018 Jul 16:1-12.
6 von Vogelsang AC,Forsberg C,Svensson M,et,al.Patients Experience High Levels of Anxiety 2 Years Following Aneurysmal Subarachnoid Hemorrhage.World Neurosurg[J].2015 Jun;83(6):1090-1097.
7 Boerboom W,van Zandvoort MJ,van Kooten F,et al.Long-term fatigue after perimesencephalic subarachnoid haemorrhage in relation to cognitive functioning,mood and comorbidity.Disabil Rehabil[J].2017,39(9):928-933.
8 Perea BartoloméMV,Ladera Fernández V,Maíllo Sánchez A.Longterm cognitive deficits in patients operated on for cerebral aneurysm by craniotomy and clipping[J].Neurologia,2009,24(6):379-385.
9 De Luca R,Lo Buono V,Leo A,et al.Use of virtual reality in improving poststroke neglect:Promising neuropsychological and neurophysiological findings from a case study[J].Appl Neuropsychol Adult.2017,22:1-5.
2 Buunk AM,Spikman JM,Veenstra WS,et al.Social cognition impairments after aneurysmal subarachnoid haemorrhage:Associationswith deficits in interpersonal behaviour,apathy,and impaired selfawareness[J].Neuropsychologia.2017,103:131-139.
3 Su J,E T,Guo Q,et al.Memory Deficits After Aneurysmal Subarachnoid Hemorrhage:A Functional Magnetic Resonance Imaging Study[J].World Neurosurg.2018,111:e500-e506.
4 Ali A,Tanirgan G,Sabanci PA,et al.Relation of gray-white matter ratio with long-term cognitive functions and quality of life in patients with mild to moderate aneurysmal subarachnoid hemorrhage:a prospective observational study[J].Acta Neurochir(Wien).2018,160(1):181-189.
5 T?lli A,H?ybye C,Bellander BM,et,al.The effect of time on cognitive impairments after non-traumatic subarachnoid haemorrhage and after traumatic brain injury[J].Brain Inj.2018 Jul 16:1-12.
6 von Vogelsang AC,Forsberg C,Svensson M,et,al.Patients Experience High Levels of Anxiety 2 Years Following Aneurysmal Subarachnoid Hemorrhage.World Neurosurg[J].2015 Jun;83(6):1090-1097.
7 Boerboom W,van Zandvoort MJ,van Kooten F,et al.Long-term fatigue after perimesencephalic subarachnoid haemorrhage in relation to cognitive functioning,mood and comorbidity.Disabil Rehabil[J].2017,39(9):928-933.
8 Perea BartoloméMV,Ladera Fernández V,Maíllo Sánchez A.Longterm cognitive deficits in patients operated on for cerebral aneurysm by craniotomy and clipping[J].Neurologia,2009,24(6):379-385.
9 De Luca R,Lo Buono V,Leo A,et al.Use of virtual reality in improving poststroke neglect:Promising neuropsychological and neurophysiological findings from a case study[J].Appl Neuropsychol Adult.2017,22:1-5.