腦中風病患的健側推倒症

Pusher Syndrome in Stroke Patients

陳至淳(Chih-Chun Chen)

《台灣老年醫學雜誌》 2卷1期 (2006/08) Pp. 42-52

https://doi.org/10.29462/TGG.200608.0004

摘要

腦中風位居我國2005年十大死因的第二位。從我國於2000年的腦血管病況流行病學調查發現，在45歲以上人口中，其發生率及死亡率明顯增高；而65歲以上老年人口腦中風死亡率為65歲以下人口的3.46倍。腦中風主要的後遺症為肢體障礙、認知障礙、言語及吞嚥障礙；在半身不遂病患的復健中，約有5%的病患可表現出以健側肢體將身體推向患側，造成所謂的「健側推倒症(pusher syndrome)」，這類病患的復原時間及住院天數均較類似疾病嚴重度病患來的長1.63倍左右，但預後卻與其他中風病患類似。特定的復健技巧可增進這類病患復健恢復的效率，以及減少醫療資源的耗用。

關鍵字

腦血管疾病 ； 半身不遂 ； 偏癱 ； 健側推倒症 ； 健側推擠傾向

並列摘要

Cerebrovascular disease had been ranked the second in the top 10 leading causes of death in Taiwan, 2005. In these stroke victims, based on the related epidemiologic survey, those above 45 usually owned higher incidence & mortality rate. Rather, the mortality rate of patients over 65 is 3.46 times higher than those under the age of 65. Major sequelae of cerebrovascular disease included musculoskeletal weakness or dysfunction, cognitive impairment, speech and swallowing disturbance. About 5% of hemiparetic/hemiplegic patients have ”pusher syndrome”. patients with this syndrome use their non-paretic limbs to push their body's long-axis to the hemiparetic/hemiplegic side. Stroke patients with pusher syndrome have stayed in the hospital 1.63 times or so longer and require a recovery period twice longer than patients without contraversive pushing, however, with the same prognosis. For these patients, specific rehabilitation programs using Bobath concept and visual cue are suggested, in order to shorten the recovery period and medical expenditure, nevertheless, further studies are still required.

並列關鍵字

contraversive pushing ； ipsilateral pushing ； pusher syndrome ； cerebral vascular disease ； hemiplegia