Sène Diouf F, Basse A M, Ndao A K, Ndiaye M, Touré K, Thiam A, Ndiaye M M, Diop A G, Ndiaye I P
Service de neurologie, CHN de Fann, Dakar, Sénégal.
Ann Readapt Med Phys. 2006 Apr;49(3):100-4. doi: 10.1016/j.annrmp.2005.11.006. Epub 2005 Dec 9.
To evaluate the functional outcome in patients followed in the department of neurology of Dakar for stroke.
Prospective longitudinal observational study from August 2003 to May 2005 included inpatients or outpatients with stroke one month or less from entry confirmed by computed tomography scan. Patients were followed monthly for 12 months. At each visit, data on functional autonomy measured by the Barthel index and the treatments received were collected.
One hundred and seventy patients aged 25 to 90 years (mean 61+/-13 years) were evaluated. The sex ratio was 0.68. A total of 64.7% of strokes involved ischemic cerebral vascular accidents and 35.3% hemorrhagic vascular accidents. Right hemiplegia was present in 55.9%, left hemiplegia in 42.9% and bilateral paresis in 1.2% of patients. A total of 28.8% of patients died between d0 and d30, 50.6% within one year. At entry, the Barthel score was greater than 60 in only 4.7% of patients. After one-year follow-up, 58.3% of the patients had a Barthel score greater than 60, 19.1% had a score between 20 and 40 and 22.6% a score between 40 and 60. Only 53.5% received rehabilitation care. The parameters significantly associated with a functional recovery were age less than 55 years (P<0.05), hemorrhagic vascular accident as opposed to ischemic vascular accident (P<0.05), and earlier rehabilitation care under qualified personnel (P<0.01).
Our study shows an important rate of mortality during the first year following stroke and the rather young age of our population. The parameters associated with a better functional recovery are comparable to most of the data in the literature. The results of our study suggest that it is possible to improve functional prognosis after stroke by setting measures of prevention of the risk factors and rehabilitation in the early management of hemiplegia.
评估在达喀尔神经病学部门接受随访的中风患者的功能转归。
2003年8月至2005年5月进行的前瞻性纵向观察研究，纳入经计算机断层扫描确诊发病一个月或以内的中风住院或门诊患者。对患者进行为期12个月的每月随访。每次随访时，收集用巴氏指数测量的功能自主性数据以及所接受的治疗情况。
评估了170例年龄在25至90岁（平均61±13岁）的患者。男女比例为0.68。总共64.7%的中风为缺血性脑血管意外，35.3%为出血性血管意外。55.9%的患者出现右侧偏瘫，42.9%出现左侧偏瘫，1.2%出现双侧轻瘫。总共28.8%的患者在第0天至第30天之间死亡，50.6%在一年内死亡。入院时，仅4.7%的患者巴氏评分大于60。经过一年的随访，58.3%的患者巴氏评分大于60，19.1%的患者评分在20至40之间，22.6%的患者评分在40至60之间。仅53.5%的患者接受了康复治疗。与功能恢复显著相关的参数为年龄小于55岁（P<0.05）、出血性血管意外而非缺血性血管意外（P<0.05）以及由合格人员进行的更早的康复治疗（P<0.01）。
我们的研究显示中风后第一年的死亡率很高，且我们的研究人群年龄相对较轻。与更好的功能恢复相关的参数与文献中的大多数数据相当。我们的研究结果表明，通过在偏瘫的早期管理中采取预防危险因素的措施和康复治疗，可以改善中风后的功能预后。
