应用心理语言评定探讨1例听失认的语言加工损害机制

发布时间：2018-04-23 08:46

本文选题：听失认 + 听理解障碍　；参考：《中国康复理论与实践》2015年08期

【摘要】：目的应用汉语失语症心理语言评定系统明确听失认患者的诊断,探讨其语言加工损害水平,并预测其语言功能的预后。方法对1例左侧颞岛顶叶、右侧颞岛叶、双侧基底节脑梗死所致的听理解严重障碍的患者,采用汉语失语症语言评定系统在发病后4周进行首次语言评定,并对其进行语言训练,发病后8周、3个月再次进行评定,分析其语言加工损害机制及预后。结果患者发病4周后,听觉词-图匹配和视觉词-图匹配正确率分别为2.5%和95.0%(P0.001);听觉语义知识和视觉语义知识正确率为5.6%和80.6%(P0.001);进一步的听觉输入通路相关检查发现得分均很低,包括声母韵母声调听辨别、最小差异单字听判断、环境声音识别;看图命名正确率67.5%,词复述0,词朗读70.0%,听写0,直接抄写100.0%;发病8周和3个月后语言评定显示,视觉词-图匹配(均100%)、视觉语义知识(97.2%、100%)完全恢复;看图命名(87.5%、90%)、词朗读(87.5%、97.5%)、看图书写(77.5%、87.5%)和抄写(均100%)有所改善;而听觉词-图匹配(5.0%、7.5%)、听觉语义知识(2.8%、5.6%)、复述(0、3.3%)和听写(均为0)未见改变。结论该例以听理解障碍(尤其是听觉语音识别缺陷)为主要语言障碍的患者诊断为听失认。通过3次评定可预测其语言功能的预后,提高这种特殊类型语言障碍患者治疗的针对性。
[Abstract]:Objective to determine the diagnosis of auditory agnosia by using the Chinese aphasia psycholinguistic assessment system, to explore the level of language processing impairment and to predict the prognosis of its language function. Methods one patient with severe hearing impairment caused by left temporal island parietal lobe, right temporal island lobe and bilateral basal ganglia infarction was evaluated for the first time 4 weeks after onset by using Chinese aphasia language assessment system. After 8 weeks and 3 months after the onset of the disease, the language processing injury mechanism and prognosis of the patients were analyzed. Results four weeks after onset, the correct rates of auditory word graph matching and visual word map matching were 2.5% and 95.0% respectively, and the correct rates of auditory semantic knowledge and visual semantic knowledge were 5.6% and 80.6% respectively. Including initial vowel tone hearing discrimination, minimum difference single word hearing judgment, environmental sound recognition, correct rate of naming, repetition 0, word reading 70.010, dictation 0, direct copying 100.0.The language assessment showed that, 8 weeks and 3 months after onset of the disease, the correct rate was 67.5%, the repetition rate was 0, the words read 70.010%, the dictation 0, and the language assessment after 8 weeks and 3 months after the onset of the disease, The visual word-map match (100%, visual semantic knowledge 97. 2 / 100) was completely restored; look at the picture name 87.5 and 90%; the word read 87.5% and 97. 5%; see the book and write 77.5% and 87.5%) and copy (both 100) improved; However, there were no changes in hearing word and graph matching 5.0 and 7.5g, the auditory semantic knowledge 2.8and 5.6and the retelling 0.3.3s) and dictation (both 0). Conclusion this case was diagnosed as auditory agnosia with hearing comprehension disorder (especially auditory speech recognition defect) as the main language disorder. The prognosis of language function can be predicted by three evaluations, and the pertinence of the treatment of this special type of language disorder can be improved.
【作者单位】：中山大学附属第一医院康复医学科;中山大学肿瘤防治中心妇科;
【分类号】：R749.1

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