右腦傷後半側忽視對日常生活功能之影響

Functional Disability in Patients of Right Hemisphere Lesions with and without Hemineglect

王和誠(Her-Cherng Wang) ； 梁秋萍(Chau-Peng Leong) ； 張瑞昆(Jui-Kun Chang) ； 林秀娟(Hsiu-Juan Lin) ； 杜國賢(Kwo-Shieng Tuo) ； 張凱嵐(Kai-Lan Chang) ； 蘇聖翔(Sheng-Hsiang Su)

《中華民國復健醫學會雜誌》 31卷3期 (2003/09) Pp. 127-132

摘要

半側忽視（hemineglect）常發生於右側大腦損傷的病人，病人對左半邊的刺激有感覺程度降低的情形。本研究的目的在於探討右腦中風或腦傷後，半側忽視的嚴重程度與日常生活功能的相關性。40位經電腦斷層或核磁共振檢查確定為右腦中風或腦傷，且符合研究條件的病人，為本研究之研究對象。然後，用Schekenberg test（線段中分測驗）是否向右側偏移10%將病人區分為半側忽視組（實驗組）與沒有半側忽視組（對照組），共得實驗組20位及對照組20位。巴氏量表（Barthel Index）用來評估病人之日常生活功能，實驗組的病人於開始加入本實驗時及之後一個月各評估一次，對照組則僅於分組時評估一次。以Schekenberg test，Albert’s test（線段刪除測驗）評估半側忽視的嚴重度，評估時間均與巴氏量表同。
研究結果：實驗組巴氏量表評估值明顯低於對照組，顯示半側忽視會影響日常生活功能。實驗組半側忽視嚴重度與巴氏量表評估值兩者之間亦有顯著相關。且實驗組加入本研究時及之後一個月再評估一次的半側忽視嚴重度及巴氏量表評估值，兩者的改善程度有明顯相關。實驗組明顯有較長的住院天數。以上結果顯示半側忽視對日常生活功能預後之影響。

關鍵字

半側忽視 ； 日常生活功能

並列摘要

Hemineglect is a common symptom and sign in patients with right hemisphere lesion. These patients usually have problems of reduced awareness of stimuli from left side. This study aims to evaluate the correlation between presence of hemineglect and functional disability in patients with right hemispheric stroke or traumatic brain injury. Forty patients who were diagnosed as right hemispheric stroke or traumatic brain injury as verified by computed tomography scan or magnetic resonance image participated in the study. Based on the criteria on Schekenberg test (line bisection test), patients were divided into two groups: 20 with hemineglect and 20 without hemineglect. Functional disability was evaluated using the Barthel index. The BI was administered to patients with neglect in the beginning of the study and one month later. For these patients without hemineglect, the Barthel index was administered in the beginning. The time administered to severity of hemineglect by the Schekenberg test and Albert’s test (line cancellation test) was the same as the Barthel Index.
The Barthel Index outcomes in patients with hemineglect were significantly lower than patients without neglect. This means that the ability to carry out activities of daily living would be affected in patients with heminegelct. Severity of hemineglect was correlated with the Barthel Index scores. Moreover, changes in severity of hemineglect from beginning to one month later were also correlated with changes in the Barthel index scores. Patients with hemineglect had significantly more hospitalization days from admission to discharge than patients without hemineglect. The results of our study showed the significant correlation of hemineglect with functional disability.

並列關鍵字

hemineglect ； activities of daily living