【作者】 余果；

【导师】 鲍伟民； 杨伯捷； 曹晓运； 谢嵘；

【作者基本信息】 复旦大学 ， 神经外科学， 2010， 硕士

【摘要】 第一部分左侧及右侧额叶肿瘤对患者执行功能的影响目的：研究左侧及右侧额叶肿瘤患者执行功能损害的特点,并进行比较,分析不同部位肿瘤造成损害之间的差别,为临床治疗提供依据和指导。方法：对50例额叶肿瘤患者(左25例,右25例)及30例健康对照组分别进行由华山医院神经心理研究所提供的一套神经心理测试量表进行有关执行功能方面的测试,这套心理量表包括：画钟测验、中国修订韦氏成人智力量表图片排列分测验、中国修订韦氏成人智力量表相似性测验,测验分别由两名研究人员采用单盲法进行,然后对所测试结果进行相关性分析。结果：1.左侧额叶肿瘤患者和健康对照组相比：画钟测验得分分别为3.32±2.21分和7.20±1.88分,(P<0.05)；中国修订韦氏成人量表图片排列分测验得分分别为13.76±7.23分和25.23±5.06分,(P<0.05);中国修订韦氏成人智力量表相似性测验得分分别为7.76±5.76分和19.27±3.34分,(P<0.05)；说明左侧额叶肿瘤组在画钟测验、韦氏成人智力量表图片排列分测验、韦氏成人智力量表相似性测验这三项测试中得分均低于对照组,差异有统计学意义。2.右侧额叶肿瘤患者和健康对照组相比：画钟测验得分分别为5.04±2.44分和7.20±1.88分,(P<0.05)；中国修订韦氏成人量表图片排列分测验得分分别为18.80±6.89分和25.23±5.06分,(P<0.05);中国修订韦氏成人智力量表相似性测验得分分别为18.16±1.95分和19.27±3.34分,(P>0.05)；说明右侧额叶肿瘤组在画钟测验和中国修订韦氏成人智力量表图片排列分测验得分低于正常对照组,差异有统计学意义。3.左侧额叶肿瘤组和右侧额叶肿瘤组组间比较,在画钟测验、韦氏成人量表图片排列分测验、韦氏成人智力量表相似性测验得分均低于右侧肿瘤组,差异有统计学意义(P<0.05)。结论：左侧额叶肿瘤组和右侧额叶肿瘤组患者的执行功能均有损害,以左侧额叶肿瘤对患者造成的损害更加严重第二部分轻度左侧额叶及左侧颞叶挫伤患者执行功能的研究目的：研究轻度左侧额叶及左侧颞叶挫伤患者执行功能损害的特点,比较不同部位脑挫伤执行功能损害的差异,为临床诊断、治疗提供依据和指导。方法：对25例轻度左侧额叶挫伤患者和25例轻度左侧颞叶挫伤患者及30例健康对照组分别进行画钟测验、中国修订韦氏成人智力量表图片排列分测验、中国修订韦氏成人智力量表相似性测验,测试采用单盲法,并对所测试结果进行相关性分析。结果：1.左侧额叶挫伤组患者和健康对照组相比：画钟测验得分分别为3.00±2.06分和7.37±1.43分,(P<0.05)；中国修订韦氏成人量表图片排列分测验得分分别为21.96±5.54分和25.83±3.86分,(P<0.05);中国修订韦氏成人智力量表相似性测验得分分别为8.44±5.00分和21.73±2.61分,(P<0.05)；说明左侧额叶挫伤组在画钟测验、韦氏成人智力量表图片排列分测验、韦氏成人智力量表相似性测验这三项测试中得分均低于对照组,差异有统计学意义。2。左侧颞叶挫伤组患者和健康对照组相比：画钟测验得分分别为4.92±2.34分和7.37±1.43分,(P<0.05)；中国修订韦氏成人量表图片排列分测验得分分别为25.56±5.04分和25.83±3.86分,(P>0.05);中国修订韦氏成人智力量表相似性测验得分分别为20.16±3.77分和21.73±2.61分,(P>0.05)；说明颞叶挫伤组仅在画钟测验得分低于健康对照组,差异有统计学意义。3.左侧额叶挫伤组和左侧颞叶挫伤组组间比较,额叶挫伤组在画钟测验、韦氏图片排列测验、韦氏相似性测验中的得分均低于颞叶挫伤组(P<0.05),差异有统计学意义。结论：轻度左侧额叶和颞叶挫伤患者的执行功能均会受到损害,其中左侧额叶挫伤的患者执行功能的损害超过了左侧颞叶挫伤患者。更多还原

【Abstract】 Part 1 Study Of Executive Functions Of Patients With Tumours In Right And Left Frontal LobeObjective:To study the impairment of executive functions of patients with tumour in right and left frontal lobe, and to explore the differences of the impairment between the two groups of patients.Methods:Twenty-five patients with tumour in left frontal lobe, twenty-five patients with tumour in right frontal lobe and thirty healthy controls were administered with neuropsychological tests for executive functions. The neuropsychological tests including Picture arrangement test of Wechsler Adult Intelligence Scale(PAT)、Similarity test of Wechsler Adult Intelligence Scale(ST) and Clock drawing test (CDT). The test were executed by two researchers, who didn’t know the informations of the participants before the experiment. Then the results were analysised.Results:In CDT test, the score of the patients with tumour in left frontal lobe is 3.32±2.21, the score of the patients with tumour in right frontal lobe is 5.04±2.44, and the healthy controls’score is 7.20±1.88. In PAT test, the score of the patients with tumour in left frontal lobe is 13.76±7.23, the score of the patients with tumour in right frontal lobe is 18.80±6.89, and the healthy controls’score is 25.23±5.06. In ST test, the score of the patients with tumour in left frontal lobe is 7.76±5.76, the score of the patients with tumor in right frontal lobe is 18.16±1.95, and the healthy controls’score is 19.27±3.34. Compared with the control group, the scores of patients with tumour in left frontal lobe are less than the healthy controls’in each targets of neuropsychology test (P＜0.05); The scores of patients with tumour in right frontal lobe are less than the healthy controls’in CDT and PAT test (P＜0.05);The scores of patients with tumour in left frontal lobe are less than the scores of patients with tumour in right frontal lobe in each targets of neuropsychology test (P＜0.05).Conclusions:the executive functions of patients with tumour in frontal lobe had obvious impairment, and the impairment of left side may be more serious.Part 2 Study Of Executive Functions Of patients With Mild Brain Contusion In Both Left Frontal Lobe And Left Temporal LobeObjective:To study the impairment of executive functions of patients with mild brain contusion in left frontal lobe and left temporal lobe, and to explore the differences of the impairment between the two groups of patients.Methods:Twenty-five patients with mild left frontal lobe contusion and twenty-five patients with mild left temporal lobe contusion, compared with thirty healthy controls, were administered with neuropsychological tests for executive functions. The neuropsychological tests including Picture arrangement test of Wechsler Adult Intelligence Scale(PAT)、Similarity test of Wechsler Adult Intelligence Scale(ST) and Clock drawing test (CDT). The test were executed by two researchers, who didn’t know the datas of the participants before the experiment. Then the results were analysised.Results:In CDT test, the score of the patients with mild left frontal lobe contusion is 3.00±2.06, the score of the patients with mild left temporal lobe contusion is 4.92±2.34 and the healthy controls’score is 7.37±1.43. In PAT test, the score of the patients with mild left frontal lobe contusion is 21.96±5.54, the score of the patients with mild left temporal lobe contusion is 25.56±6.15 and the healthy controls’score is 25.83±3.86. In ST test, the score of the patients with mild left frontal lobe contusion is 8.44±5.00, the score of the patients with mild left temporal lobe contusion is 20.16±3.77 and the healthy controls’score is 21.73±2.61. Compared with the control group, the scores of patients with mild left frontal lobe contusion are lower than the healthy controls’in each targets of neuropsychology test (P＜0.05); The score of patients with mild left temporal lobe contusion is lower than the healthy controls’only in CDT test (P＜0.05); The scores of patients with mild left frontal lobe contusion are lower than the scores of patients with mild left temporal lobe contusion in each targets of neuropsychology test (P＜0.05). Conclusion:The executive functions of patients with mild brain contusion in left frontal lobe and left temporal lobe had obvious impairment, and the impairment of left frontal lobe contusion may be more serious.更多还原