Department of Neurology, Orebro University Hospital, Sweden.
Acta Neurol Scand. 2010 Jun;121(6):359-69. doi: 10.1111/j.1600-0404.2009.01258.x. Epub 2009 Nov 30.
Beyond epidemiological differences, it has been controversial whether any important sex differences exist in the treatment of stroke. In this review paper, the following areas are covered: thrombolysis, stroke unit care, secondary prevention, surgical treatment, and rehabilitation. Additionally, symptoms at stroke onset, as well as outcome measures, such as death, dependency, stroke recurrence, quality of life, and depression are reviewed.
Search in PubMed, tables-of-contents, review articles, and reference lists after studies that include information about sex differences in stroke care.
Ninety papers are included in this review. Women suffer more from cortical and non-traditional symptoms. Men and women benefit equally from thrombolysis and stroke unit care. Women with cardioembolic strokes may benefit more from anticoagulant therapy. Most studies have not found any tendency towards sexism in the choice of treatment. Post-stroke depression and low quality-of-life seem to be more common among women. Mortality rates are higher among men in some studies, while long-term ADL-dependency seems to be more common among women.
Sex differences in stroke treatment and outcome are small, with no unequivocal proof of sex discrimination. Women have less favourable functional outcome because of higher age at stroke onset and more severe strokes.
除了流行病学差异之外，在脑卒中治疗方面是否存在任何重要的性别差异一直存在争议。在这篇综述文章中，涵盖了以下领域：溶栓治疗、卒中单元护理、二级预防、手术治疗和康复。此外，还回顾了卒中发病时的症状以及死亡、依赖、卒中复发、生活质量和抑郁等预后指标。
在 PubMed 中搜索，查阅目录、综述文章以及参考文献列表，寻找包含脑卒中护理中性别差异信息的研究。
本综述纳入了 90 篇论文。女性更多地患有皮质和非传统症状。男性和女性从溶栓治疗和卒中单元护理中获益相同。患有心源性栓塞性卒中的女性可能从抗凝治疗中获益更多。大多数研究未发现治疗选择上存在性别歧视的倾向。卒中后抑郁和生活质量较低在女性中更为常见。一些研究中男性的死亡率较高，而长期 ADL 依赖在女性中更为常见。
脑卒中治疗和预后方面的性别差异较小，没有明确证据表明存在性别歧视。女性的功能预后较差，因为其卒中发病年龄更大，且卒中更严重。
