腦梗塞病人預後與電腦斷層掃描之關係

Brain CT in Prediction of the Prognosis of Ischemic Stroke

王錦滿(Chin-Man Wang) ； 鄧復旦(Fuk-Tan Tang) ； 黃美涓(May-Kuen Wong)

《中華民國復健醫學會雜誌》 18期 (1990/12) Pp. 136-141

摘要

本研究為探討腦梗塞後病患預後是否能及早預測，自民國73年6月至78年2月共收集107例，將其按電腦斷層掃描之發現，依病灶之大小深淺分為七組，而預後之情況則依日常生活獨立程度與步行能力分為四等級。結果發現預後較佳者，依次為電腦斷層掃描無不正常發現組、深部病灶組及腦幹梗塞組。而預後較差者則依次為多發性兩側半球病灶組、合併表淺與深部病灶組及大範圍的表淺性病灶組。於就業情形與收入狀況方面，則七組均有減少之現象，減少之程度則各組間沒有顯著差異。

關鍵字

電腦斷層掃描 ； 腦梗塞 ； 預後

並列摘要

This study was carried out on 107 cases with cerebral infarcts for investigation of prognosis in Chang Gung Memorial Hospital from July 1984 to Feb. 1989. Parameters studied were age. sex. lesion size. neuroanatomic lesion site. lateralization of lesions. follow up duration (＞6 months), receive of rehabilitation program or not. and the working status and income status before and post-stroke.
According to the size and depth of hypodensity the brain computerized tomograms were classified into seven groups: Group 1:normal, Group 2:small superficial infarct, Group3:large superficial infarct. Group 4:deep infarct, Group 5:deep and large superficial infarcts, Group 6:bilateral hemispheres infarcts, Group 7:bram stem infarct. The prognosis of these patients had been placed in four groups by depenency of　ADL and ability in ambulation: Group A:mormal, Group B:ADL independent, ambulation with device, Group C:ADL partial dependent, ambulation with device, Group D:ADL total dependent and incontinence. We found good prognosis sequentially as Group 1, Group 4, Group 7 and the poor prognosis are Group 6, Group5, Group3. There were no significant difference in age, sex, lateralization of lesions, follow up duration and receive of rehabilitation program or not. Most of our patients had lost their jobs and had lower income after stroke in all groups except group 1, but seems not parallel to the severity of neurological damage.