Rimmele David Leander, Thomalla Götz
Klinik und Poliklinik für Neurologie, Universitätsklinik Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2022 Apr;65(4):498-502. doi: 10.1007/s00103-022-03505-2. Epub 2022 Mar 8.
The treatment of stroke has significantly improved over the past two decades, resulting in reduced mortality and morbidity in high-income countries. However, strokes remain the third leading cause of mortality and disability worldwide. In addition to acute care and the prevention of risk factors, treatment of the various persisting disabilities that impact the daily activities and quality of life of patients also remain important. Motor and language deficits affect everyday life most obviously. Other deficits may involve complex movements, sensory, and cognitive functions. Patients also often suffer from anxiety, fatigue, and depression.Established ergotherapeutic, physiotherapeutic, and logopedic programs exist for motor and language deficits for in-patient treatment as well as in the ambulatory setting. The diagnosis and treatment of cognitive impairments and behavioral disorders, however, are largely confined to the early rehabilitation phase. Despite indications of a long-term impairment of quality of life due to cognitive deficits and behavioral disorders, previous study results speak against drug-based antidepressant therapy in in-patient rehabilitation. Individual patient-reported outcomes, supported by screening for cognitive deficits and consideration of individual risk factors and coping strategies, could further improve the treatment of stroke and its long-term burden.
在过去二十年中，中风的治疗有了显著改善，高收入国家的死亡率和发病率有所降低。然而，中风仍是全球第三大致死和致残原因。除了急性护理和危险因素预防外，治疗影响患者日常活动和生活质量的各种持续残疾也很重要。运动和语言缺陷对日常生活影响最为明显。其他缺陷可能涉及复杂运动、感觉和认知功能。患者还经常遭受焦虑、疲劳和抑郁之苦。针对运动和语言缺陷，已有成熟的职业治疗、物理治疗和言语治疗方案用于住院治疗以及门诊治疗。然而，认知障碍和行为障碍的诊断和治疗主要局限于早期康复阶段。尽管有迹象表明认知缺陷和行为障碍会长期损害生活质量，但先前的研究结果不支持在住院康复中使用药物进行抗抑郁治疗。通过筛查认知缺陷并考虑个体风险因素和应对策略来支持的个体患者报告结果，可能会进一步改善中风治疗及其长期负担。
