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轻度头部损伤一年后的神经精神后遗症。

Neuropsychiatric sequelae one year after a minor head injury.

作者信息

Deb S, Lyons I, Koutzoukis C

机构信息

Division of Psychological Medicine, University of Wales College of Medicine, Heath Park, Cardiff, UK.

出版信息

J Neurol Neurosurg Psychiatry. 1998 Dec;65(6):899-902. doi: 10.1136/jnnp.65.6.899.

Abstract

OBJECTIVE

To assess neuropsychiatric sequelae 1 year after minor head injury in a cross sectional study using home interviews with patients and their relatives at 1 year after head injury.

METHODS

The study cohort included 148 adults who were admitted to hospital after a minor head injury between 1 July 1994 and 30 June 1995 and showed clinical or radiological evidence of brain injury. Main outcome measures used in the study were the Glasgow outcome scale, Edinburgh rehabilitation status scale, Barthel index, clinical interview schedule-revised, mini mental state examination, and assessment of symptoms of postconcussional syndrome.

RESULTS

At one year follow up, four (2.9%) patients had a severe disability, 35 (25.5%) had a moderate disability, and 95 (69.3%) had no disability according to the Glasgow outcome scale. A slightly higher proportion (33.3%, n=45) showed disability according to the Edinburgh rehabilitation status scale. Thirty one patients (23.1%) scored <24 in the mini mental state examination. These were mostly patients over the age of 65. Twenty three patients (17.2%) were diagnosed as psychiatric cases according to the clinical interview schedule-revised scale. Seventy four (55.2%) patients showed one of the symptoms of postconcussional syndrome. The most commonly shown neurobehavioural problems were irritability (30%), sleep disturbance (29%), and impatience (27%).

CONCLUSION

One year after a minor head injury, a substantial proportion of patients showed neuropsychiatric sequelae.

摘要

目的

在一项横断面研究中,通过在头部受伤1年后对患者及其亲属进行家访,评估轻度头部受伤1年后的神经精神后遗症。

方法

研究队列包括148名成年人,他们在1994年7月1日至1995年6月30日期间因轻度头部受伤入院,并显示出脑损伤的临床或放射学证据。该研究使用的主要结局指标包括格拉斯哥结局量表、爱丁堡康复状态量表、巴氏指数、修订版临床访谈问卷、简易精神状态检查表以及对脑震荡后综合征症状的评估。

结果

根据格拉斯哥结局量表,在1年随访时,4名(2.9%)患者有严重残疾,35名(25.5%)有中度残疾,95名(69.3%)无残疾。根据爱丁堡康复状态量表,显示残疾的比例略高(33.3%,n = 45)。31名患者(23.1%)在简易精神状态检查表中的得分<24分。这些大多是65岁以上的患者。根据修订版临床访谈问卷量表,23名患者(17.2%)被诊断为精神病例。74名(55.2%)患者表现出脑震荡后综合征的一种症状。最常见的神经行为问题是易怒(30%)、睡眠障碍(29%)和不耐烦(27%)。

结论

轻度头部受伤1年后,相当一部分患者出现神经精神后遗症。

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