We report on silent brain infarction (SBI) and leuko- araiosis (LA) of 23 patients with clinically diagnosed “first-ever” acute ischemic lacunar stroke. The lacunar syndromes were pure motor hemiparesis (10), pure s...We report on silent brain infarction (SBI) and leuko- araiosis (LA) of 23 patients with clinically diagnosed “first-ever” acute ischemic lacunar stroke. The lacunar syndromes were pure motor hemiparesis (10), pure sensory syndrome (2), ataxic hemiparesis (3), dysarthria clumsy hand syndrome (3), and sensory- motor deficit (5). Nineteen out of the 23 patients presented with completed strokes on arrival to the hospital, and 4 (17%) developed evolving-stroke within 24 hours of stroke onset. A lacune corresponded to the acute stroke could be found in all patients on brain magnetic resonance imaging (MRI), and in 18 (78%) on brain computed tomography (CT). MRI showed additional subclinical or asymptomatic “silent brain infarctions or lacunes” (SBI) in 19 (83%) of 23 patients, and leuko-araiosis (LA) of moderate to severe degree (> grade 2) was present in 61% of patients although dementia was absent. Hypertension is the risk factor in 78% of cases followed by diabetes mellitus, smoking, and elevated plasma cholesterol level. Independence of the types of lacunar syndromes, patients with hypertension and diabetes mellitus are associated with high grade LA. None with normal blood pressure and plasma glucose had grade 3 or grade 4 LA (p < 0.05). In conclusion, evolving-stroke occurs in one- fifth of patients with “first-ever” lacunar infarct within the first 24 hours of stroke onset. SBI was found in 83% of cases. Hypertension and diabetes mellitus are associated with additional SBI and high grade LA. The severity of leuko-araiosis per se dictates the cerebrovascular risks.展开更多
目的:探讨基于情绪智力模型的护理对首发缺血性脑卒中病人卒中后疲乏症状的干预效果。方法:选取2023年6月—2024年10月江南大学附属医院收治的157例首发缺血性脑卒中病人作为研究对象,采用随机数字表法将其分为对照组78例、观察组79例...目的:探讨基于情绪智力模型的护理对首发缺血性脑卒中病人卒中后疲乏症状的干预效果。方法:选取2023年6月—2024年10月江南大学附属医院收治的157例首发缺血性脑卒中病人作为研究对象,采用随机数字表法将其分为对照组78例、观察组79例。对照组实施常规护理,观察组实施基于情绪智力模型的护理,比较两组疲乏程度(疲劳严重程度量表)、情绪状态[医院焦虑抑郁量表(Hospital Anxiety and Depression Scale,HADS)]及应对能力。结果:干预后,观察组疲劳严重程度量表、焦虑、抑郁、屈服、回避评分低于对照组;面对维度评分高于对照组(P<0.05)。结论:基于情绪智力模型的护理可有效改善首发缺血性脑卒中病人疲乏症状,减轻其焦虑、抑郁负性情绪,积极应对疾病。展开更多
目的探讨首发脑卒中患者残疾接受度轨迹及影响因素。方法选取温州市中心医院2022年12月至2023年12月收治的202例首发脑卒中患者,根据患者出院后残疾接受度轨迹分为低接受度组(n=38)、中接受度组(n=96)和高接受度组(n=68)。多因素Logisti...目的探讨首发脑卒中患者残疾接受度轨迹及影响因素。方法选取温州市中心医院2022年12月至2023年12月收治的202例首发脑卒中患者,根据患者出院后残疾接受度轨迹分为低接受度组(n=38)、中接受度组(n=96)和高接受度组(n=68)。多因素Logistic回归分析影响首发脑卒中患者残疾接受度的影响因素。结果脑卒中患者伤残接受度量表(acceptance of disability scale-revised,ADS-R)总分为(89.93±13.51)分。三组在年龄、文化程度、家庭月均收入、有无照顾者、病情严重程度、医疗社会支持量表(medical social support scale,MOS-SSS)评分、Herth希望量表评分及9条目病人健康问卷抑郁量表评分比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄(OR=12.419,95%CI:3.967~38.882)、无照顾者(OR=5.793,95%CI:1.989~16.875)、病情严重程度(OR=5.724,95%CI:1.927~16.999)是影响首发脑卒中患者残疾接受度的危险因素(P<0.05),文化程度(OR=0.207,95%CI:0.069~0.624)、家庭月均收入(OR=0.238,95%CI:0.079~0.712)、MOS-SSS评分(OR=0.502,95%CI:0.303~0.832)是保护因素(P<0.05)。结论首发脑卒中患者残疾接受度呈现3种不同的轨迹,年龄、有无照顾者、病情严重程度、文化程度、家庭月均收入和MOS-SSS评分是首发脑卒中患者残疾接受度的影响因素,可作为预测残疾接受度轨迹的因素。展开更多
文摘We report on silent brain infarction (SBI) and leuko- araiosis (LA) of 23 patients with clinically diagnosed “first-ever” acute ischemic lacunar stroke. The lacunar syndromes were pure motor hemiparesis (10), pure sensory syndrome (2), ataxic hemiparesis (3), dysarthria clumsy hand syndrome (3), and sensory- motor deficit (5). Nineteen out of the 23 patients presented with completed strokes on arrival to the hospital, and 4 (17%) developed evolving-stroke within 24 hours of stroke onset. A lacune corresponded to the acute stroke could be found in all patients on brain magnetic resonance imaging (MRI), and in 18 (78%) on brain computed tomography (CT). MRI showed additional subclinical or asymptomatic “silent brain infarctions or lacunes” (SBI) in 19 (83%) of 23 patients, and leuko-araiosis (LA) of moderate to severe degree (> grade 2) was present in 61% of patients although dementia was absent. Hypertension is the risk factor in 78% of cases followed by diabetes mellitus, smoking, and elevated plasma cholesterol level. Independence of the types of lacunar syndromes, patients with hypertension and diabetes mellitus are associated with high grade LA. None with normal blood pressure and plasma glucose had grade 3 or grade 4 LA (p < 0.05). In conclusion, evolving-stroke occurs in one- fifth of patients with “first-ever” lacunar infarct within the first 24 hours of stroke onset. SBI was found in 83% of cases. Hypertension and diabetes mellitus are associated with additional SBI and high grade LA. The severity of leuko-araiosis per se dictates the cerebrovascular risks.
文摘目的:探讨基于情绪智力模型的护理对首发缺血性脑卒中病人卒中后疲乏症状的干预效果。方法:选取2023年6月—2024年10月江南大学附属医院收治的157例首发缺血性脑卒中病人作为研究对象,采用随机数字表法将其分为对照组78例、观察组79例。对照组实施常规护理,观察组实施基于情绪智力模型的护理,比较两组疲乏程度(疲劳严重程度量表)、情绪状态[医院焦虑抑郁量表(Hospital Anxiety and Depression Scale,HADS)]及应对能力。结果:干预后,观察组疲劳严重程度量表、焦虑、抑郁、屈服、回避评分低于对照组;面对维度评分高于对照组(P<0.05)。结论:基于情绪智力模型的护理可有效改善首发缺血性脑卒中病人疲乏症状,减轻其焦虑、抑郁负性情绪,积极应对疾病。
文摘目的探讨首发脑卒中患者残疾接受度轨迹及影响因素。方法选取温州市中心医院2022年12月至2023年12月收治的202例首发脑卒中患者,根据患者出院后残疾接受度轨迹分为低接受度组(n=38)、中接受度组(n=96)和高接受度组(n=68)。多因素Logistic回归分析影响首发脑卒中患者残疾接受度的影响因素。结果脑卒中患者伤残接受度量表(acceptance of disability scale-revised,ADS-R)总分为(89.93±13.51)分。三组在年龄、文化程度、家庭月均收入、有无照顾者、病情严重程度、医疗社会支持量表(medical social support scale,MOS-SSS)评分、Herth希望量表评分及9条目病人健康问卷抑郁量表评分比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄(OR=12.419,95%CI:3.967~38.882)、无照顾者(OR=5.793,95%CI:1.989~16.875)、病情严重程度(OR=5.724,95%CI:1.927~16.999)是影响首发脑卒中患者残疾接受度的危险因素(P<0.05),文化程度(OR=0.207,95%CI:0.069~0.624)、家庭月均收入(OR=0.238,95%CI:0.079~0.712)、MOS-SSS评分(OR=0.502,95%CI:0.303~0.832)是保护因素(P<0.05)。结论首发脑卒中患者残疾接受度呈现3种不同的轨迹,年龄、有无照顾者、病情严重程度、文化程度、家庭月均收入和MOS-SSS评分是首发脑卒中患者残疾接受度的影响因素,可作为预测残疾接受度轨迹的因素。
