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題名 | 全失性失語症病因之探討 |
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作者姓名(中文) | 陳思甫; 劉燦宏; 謝富美; 連倚南; | 書刊名 | 復健醫學會雜誌 |
卷期 | 22:2 1994.12[民83.12] |
頁次 | 頁37-43 |
分類號 | 415.847 |
關鍵詞 | 全失性失語症; 腦梗塞; 腦出血; 外傷性腦傷; Global aphasia; Cerebral infarction; Cerebral hemorrhage; TBI; |
語文 | 中文(Chinese) |
中文摘要 | 全失性失語症是失語症中最嚴重的一型,因為病人語言及神經功能都遭受很大的障礙,因此對復健團隊而言是一項高難度的挑戰。 本研究為了瞭解國內全失性失語症之病因,以1990年6月至1993年5月間因並失性失語症到臺大醫院復健部接受治療的個案為研究對象,共計51例;採回溯法查閱病歷及影像學的檢查,整理出發生全失性失語症之病因。 51個病例中,男性33例、女性18例,年齡自10歲至86歲,平均56.1±14.5歲;歸納病因可分成二類:一類是腦血管病變共42例,包括腦梗塞22例、高血壓性腦出血16例、動脈瘤破裂3例、動靜脈畸形1例;另一類是非腦血管病變共9例,包括外傷性腦傷7例、腦腫瘤1例皮腦膿瘍1例。經統計發現全失性失語症之病因中,腦血管病變的病例較多(p<0.05)。就性別而言,腦出血及外傷性腦傷之病例,發生全失性失語症的機率,男性明顯多於女性(p<0.05)。年齡方面,以腦梗塞病例年齡(61.6±14.3)較大,但不具統計意義。 就分項病因而言,腦梗塞之病例皆肇因於中大腦動脈區域發生梗塞,其中全區較多有14例(63.6%),皮質下區有6例(27.3%),後區有2例(9.1%)。殼核出血的病例中,藉由Image-Pro Plus軟體估算出血量,發現大於35ml的病例較多,共有10例(71.4%),16ml-35ml者有四例(28.6%);經統計發現大於35ml之病例,發生全失性失語症之機率較高(p<0.05)。 本文將病例依性別、年齡、病因、梗塞部位及出血量大小加以分組討論,希望除了探討全失性失語症的病因之外也能以此分類為基礎,追蹤觀察這些病例的預後;而與預後相關的因素,也將是我們新的研究方向。 |
英文摘要 | Global aphasia is the most severe form of language impairment that occurs following focal brain damage. Since communication and neurological functions inpatients with global aphasia are seriously impaired, it is a real challenge to the rehabilitation team. The study was designed to determine the etiology of global aphasia, to find out any relationship between different etiology and age or sex. Fifty-one patient with global aphasia attending to the Department of Physical Medicine and Rehabilitation of National Taiwan University Hospital from June 1990 to May 1993, were surveyed for the etiology of aphasia. Of the 51 patients (33 males and 18 females), the mean age was 56.1±14.5 years. The etiology could be classified into 2 groups; group 1, vascular etiology, including 22 cerebral infarction, 16 cerebral hemorrhage, 3 cerebral aneurysm, 1 arterio-venous malformation; group 2, non-vascular etiology, 7 traumatic brain injury, 1 brain tumor and 1 brain abscess. Patients with vascular etiology were predominant in global aphasics (p<0.05). In view of age and gender, male patient was predominant in patients with traumatic brain injury and cerebral hemorrhage (p<0.05), but no difference in the group of cerebral infarction. There was also no difference in the mean age between patients with vascular etiology and traumatic brain injury. As for vascular origin, all global aphasic patients caused by cerebral infarction were the victims of middle cerebral artery territory infarct. The sample included 14 full territory infarct, 6 subcortical infarct and 2 posterior infarct. The majority of these cases was caused by full territory infarct. Putaminl hemorrhage could be grouped into 3 groups according to the volume of hematoma: large (>35ml), medium (16-35ml) and small (<15ml). In our series of 14 cases of putaminal hemorrhage with global aphasia, 10 cases had large hematoma, 4 cases medium hematoma, but none with small lesion of hemorrhage. It is obvious that global aphasia is usually associated with large hematoma. This study investigated different factors associated with global aphasia. Including age, sex, etiology, lesion site and size. Factors which related to the prognosis of global aphasia will be presented in the subsequent study. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。