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中风恢复情况及影响预后的因素

The profile of recovery from stroke and factors influencing outcome.

作者信息

Kotila M, Waltimo O, Niemi M L, Laaksonen R, Lempinen M

出版信息

Stroke. 1984 Nov-Dec;15(6):1039-44. doi: 10.1161/01.str.15.6.1039.

Abstract

The recovery from stroke of 154 survivors out of 255 stroke patients was analyzed. The outcomes documented were: discharge from hospital, activities of daily living (ADL) and return to work. A clear improvement in neurological and neuropsychological deficits was seen from the acute stage to three months, and this continued to twelve months, but to a lesser degree. 69% and 78% respectively, of the patients were at home three and twelve months after stroke. Independence in ADL increased from 32% acutely to 62% and 68% by three and twelve months, respectively. Of those gainfully employed prior to stroke, 55% had returned to work after twelve months. As a group, SAH patients seemed to recover better, but, for those that could be age-matched with infarction patients, there was no difference in outcome. Old age, acute stage hemiparesis, impairment of intelligence and memory, visuoperceptual deficits, nonadequate emotional reactions, and living alone all had a major negative influence on outcome. This study suggests that neurological and neuropsychological deficits, as well as emotional reactions, influence the outcomes after stroke, and all should be taken into consideration in prognosis.

摘要

对255名中风患者中的154名幸存者的中风恢复情况进行了分析。记录的结果包括:出院情况、日常生活活动能力(ADL)和重返工作岗位情况。从中风急性期到三个月,神经和神经心理缺陷有明显改善,这种改善持续到十二个月,但程度较小。分别有69%和78%的患者在中风后三个月和十二个月时在家中。ADL的独立能力从急性期的32%分别增加到三个月时的62%和十二个月时的68%。在中风前有工作的患者中,55%在十二个月后重返工作岗位。作为一个群体,蛛网膜下腔出血(SAH)患者似乎恢复得更好,但是,对于那些可以与梗死患者进行年龄匹配的患者,结果没有差异。老年、急性期偏瘫、智力和记忆力受损、视觉感知缺陷、不适当的情绪反应以及独居都对结果有重大负面影响。这项研究表明,神经和神经心理缺陷以及情绪反应会影响中风后的结果,在预后中都应予以考虑。

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