Provinciali L, Ceravolo M G
Clinica di Neuroriabilitazione, Università degli Studi di Ancona.
Ann Ital Med Int. 1996 Oct;11 Suppl 2:110S-116S.
The aim of this study was to identify the most appropriate clinical management of the subacute stage after stroke, in order to reduce mortality and control disability following cerebrovascular disease. Data were collected from international journals, books and guidelines written by accredited agencies and scientific societies. Reviews and clinical investigations written by authors operating in stroke assistance facilities have been selected among those submitted to accredited scientific journals, spontaneously or upon request by editors of specific sections or supplements. Furthermore, the guidelines proposed by either scientific or lay associations have been considered. The following elements have been considered: i) prevention of morbidity and treatment of complications in the subacute phase; ii) identification of uncommon stroke causative factors in order to prevent recurrent events; iii) prognosis of survival and disability; iv) activation of rehabilitation. Results show that a careful evaluation of stroke etiology and the direct management of cerebrovascular problems by specialized utilities bring about an increase in survival rate and reduce disability. The treatment of complications, the evaluation of recovery capacity and the accomplishment of rehabilitation strategies, based on accredited criteria of organization, allow an increase in the efficiency of assistance facilities. Involvement of the family has a positive influence on autonomy. In conclusion, the qualified management of stroke patients can reduce mortality and disability, even if there is still no effective therapy, capable of reducing cerebral damage.
本研究的目的是确定中风亚急性期最合适的临床管理方法，以降低脑血管疾病后的死亡率并控制残疾情况。数据收集自国际期刊、书籍以及由权威机构和科学协会编写的指南。在提交给权威科学期刊的文献中，无论是自发提交还是应特定板块或增刊编辑要求提交的文献，都挑选了由中风辅助设施领域的作者撰写的综述和临床研究。此外，还考虑了科学或非专业协会提出的指南。考虑了以下因素：i）亚急性期并发症的预防和治疗；ii）识别不常见的中风病因以预防复发事件；iii）生存和残疾预后；iv）康复启动。结果表明，对中风病因进行仔细评估以及由专业机构直接处理脑血管问题可提高生存率并减少残疾。基于权威组织标准对并发症进行治疗、对恢复能力进行评估以及实施康复策略，可提高辅助设施的效率。家庭参与对自主性有积极影响。总之，即使仍然没有能够减少脑损伤的有效疗法，对中风患者进行专业管理也可降低死亡率和残疾率。
