腦中風患者復健治療預後之探討

Outcome of Rehabilitation of Stroke Patients in Recent 10 Years

許美慧(Mei-Hue Hsu)

《中華民國復健醫學會雜誌》 24卷1期 (1996/06) Pp. 41-49

https://doi.org/10.6315/JRMA.199606.0004

摘要

為瞭解腦中風患者接受復健治療及其預後之情形，本文以回溯性研究方式，以國泰綜合醫院近十年來因腦中風住院，做過電腦斷層檢查且接受復健治療之患者為研究對象（共1419人），依入院時間分為兩組，第一組以前五年（七十一年七月至七十六年六月，共536例，第二組為後五年（七十六年七月至八十一年六月，共883例。），就日常生活自理能力及獨立行走能力比較兩組復健治療之預後。整體而言，腦中風患者經復健治療後，其日常生活自理能力者第一組由15.0%增至41.6%，第二組由20.4%增至44.3%； 具獨立行走能力者第一組由50.3%增至82.7%；第二組由51.6%增至85.6%，兩組都有顯著進步，但組間無明顯差別。
腦中風之類別、發生次數及被殼出血患者接受手術治療與否對復健治療之預後無顯著影響。經復健治療後，腦中風伴感覺及語言障礙、大於四十五歲及於腦中風後二週內及二至四週接受復健治療之患者，其日常生活自理能力及獨立行走能力兩組均有顯著進步，而伴情緒及認知障礙患者，則日常生活自理能力兩組均無顯著進步，而獨立行走能力兩組均有顯著進步，至於伴癡呆症，小於四十五歲及於腦中風後四至六週才接受復健治療之患者則日常生活自理能力兩組無明顯進步，而獨立行走能力則僅第二組有顯著進步。至於各項復健治療之預後則兩組組間均無顯著差異。
本文在復健治療上的結果，可作為台灣地區腦中風住院患者治療上的重要參考指標。

關鍵字

腦中風 ； 復健治療預後 ； 日常生活活運動 ； 行走

並列摘要

In recent 10 years 1419 stroke patients who had been hospitalized to Cathy General Hospital, and received CT scanning examinations were retrospectively selected for this study. These patients were divided into two groups. The first group was enrolled from July 1982 to June 1987 (total 536 patients) and the second was from July 1987 to June 1992 (total 883 patients). The outcome of rehabilitation was evaluated according to the abilities of daily living and ambulation.
In general, the stroke patients had the abilities of activities of daily living from 15% to 41.6% in Group 1 and from 20.4% to 44.3% in Group 2. Patients had the ability of ambulation from 50.3% to 82.7% in Group 1 and from 51.6% to 85.6% in Group 2 after rehabilitation. There was a significant improvement in these two groups (p＜0.005, respectively). The type of stroke, frequency of recurrence and putaminal hemorrhage with or without operation did not influence the outcome of rehabilitation.
After rehabilitation, the stroke patients accompanied with sensory impairment, speech disorder, the onset age more than 45 years and starting rehabilitation within two weeks and two to four weeks after onset all had significant improvement in the abilities of daily living and ambulation in these two groups. The patients accompanied with emotional, cognitive, and perceptive disturbance had no significant improvement in the abilities of daily living but there was a significant improvement in the ability of ambulation in these two groups. The patients accompanied with dementia, onset age less than 45 years and starting rehabilitation 4 to 6 weeks after onset had no significant improvement in the abilities of activities of daily living in both groups but there was a significant improvement in the ability of ambulation in Group 2 patients.

並列關鍵字

stroke ； outcome of rehabilitation ； activities of daily living ； ambulation