Barolin G S, Koppi S
Ludwig-Boltzmann-Institut für Neurorehabilitation, Neurologischen Abteilung des Vorarlberger Landes-Nervenkrankenhauses Valduna.
Wien Med Wochenschr. 1988 Feb 15;138(3):62-72.
Adequate help for the apoplectic patient according to recent standards can be given only by simultaneous and equivalent orientation towards both acute therapy and rehabilitation, which should merge smoothly into each other. This can be achieved only by specialised hospitalisation. The idea of totally domestic treatment, as advocated in times past, has to be abandoned for good. In the foreground of acute therapy are treatment of edema, cardiac output and blood pressure, rheological factors: blood viscosity, thrombocyte aggregation, erythrocyte elasticity. In the foreground of rehabilitation efforts we place the principle of "totality and permanence" regardless of prognostic selectivity. The principle of permanence refers to rehabilitative efforts from the very beginning to long-term rehabilitation for months and years with the help of our special rehabilitation service and systematic training of relatives. At least, it has to be stressed that the rehabilitation patient is not a medical waste product and not a symbol of medical surrender either. It would be unfair and senseless to help him through the acute phase and leave him alone during his rehabilitation period. Permanent attention for the apoplectic patient is essential within a system of social medicine. Much is lacking in this respect, as far as academic institutions, advanced training, and information is concerned. We hope that we herewith demonstrate that not only the acute therapy, but also the rehabilitation of the apoplectic patient is a field of scientific fascination, still being in consequent further development. It is intended to give an additional stimulus for the optimal after-care of the apoplectic.
只有同时且同等重视急性治疗和康复,并使两者顺利衔接,才能按照最新标准为中风患者提供充分的帮助。这只有通过专科住院治疗才能实现。过去所倡导的完全居家治疗的理念必须彻底摒弃。急性治疗的重点在于治疗水肿、心输出量和血压、流变学因素:血液粘度、血小板聚集、红细胞弹性。在康复工作中,我们将“整体性和持久性”原则置于首位,而不考虑预后的选择性。持久性原则是指从一开始到长达数月乃至数年的长期康复过程,借助我们特殊的康复服务以及对亲属的系统培训来进行康复努力。至少必须强调,康复患者既不是医疗废品,也不是医疗放弃的象征。在急性期帮助他而在康复期将他弃之不顾是不公平且毫无意义的。在社会医学体系中,对中风患者给予持续关注至关重要。在学术机构、进修培训和信息方面,这方面存在诸多不足。我们希望借此表明,中风患者的治疗不仅急性治疗,而且康复也是一个充满科学魅力的领域,仍在持续深入发展。旨在为中风患者的最佳后续护理提供额外的推动。