缺血性腦中風患者功能預後之影響因素

Factors Influencing Functional Outcomes in Ischemic Stroke Patients

廖麗君(Lih-Jiun Liaw) ； 林昭宏(Jau-Hong Lin) ； 林瑞泰(Ruey-Tay Lin) ； 劉景寬(Ching-Kuan Liu)

《中華民國物理治療學會雜誌》 24卷6期 (1999/11) Pp. 408-419

https://doi.org/10.29616/JPTAROC.199911.0005

摘要

本研究目的是以前瞻性方式探討影響腦中風患者發病三個月功能預後之相關因素。本研究以高雄醫學院附設中和紀念醫院民國八十四年十二月至八十八年二月底因缺血性腦中風住院於神經內科的335位患者為對象，收集腦中風患者社會人口學、住院期間臨床診斷評估資料和功能獨立自主量表（共分自我照顧、排便、移位、走動、溝通、社會認知等六大項，總分為126分）及簡易智能狀態量表作為相關影響變項。中風後三個月共有255位患者接受門診追蹤並完成功能獨立自主量表得分表現和簡易智能狀態量表之再評估。以三個月後功能獨立自主量表及期間進步量作為功能預後的兩項指標。統計分析結果顯示影響中風患者三個月後功能恢復的重要因素包括年齡、住院天數、進食能力、小便控制、步行能力、住院時之認知功能、布氏患側肢體上肢近端及下肢運動恢復功能以及是否有多處梗塞部位；而影響三個月期間功能改善進步量的重要因素包括進食能力、布氏患側肢體上肢近端和遠端運動恢復功能及步行能力。

關鍵字

缺血性中風 ； 功能預後

並列摘要

The purpose of this prospective study was to investigate factors relating to functional outcomes in stroke patients at 3 months since onset. A cohort of 335 ischemic stroke patients who were consecutively admitted as inpatient to the Neurology Department at Kaohsiung Medical University Hospital between December 1, 1995 and February 28, 1999 were included in this study. Sociodemographic and clinical factors, Functional Independence Measure (FIM) score, Mini-Mental Status Examination (MMSE) and cranial computed tomography findings were collected during hospitalization period. At 3 months following the onset of stroke, the FIM and MMSE scores were retested in 255 patients during their outpatient visits at the Neurologic Clinic. FIM score at 3-month follow-up and improvement gains were used as the prognostic indices. Statistical analyses indicated that significant factors related to functional recovery included age, location of brain lesion, length of stay, eating ability, urinary control, gait ability, Brunnstrom recovery stages of the affected limbs and MMSE score at acute stage during hospitalization. Furthermore, the result from multiple regression analysis revealed that eating ability, gait ability, and Brunnstrom stages of the affected upper limb were significant predictors of functional improvement at 3 month.

並列關鍵字

Ischemic stroke ； Functional outcome