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題 名 | Reflex Sympathetic Dystrophy Syndrome in Stroke Patients with Hemiplegia-three Phase Bone Scintigraphy and Clinical Characteristics=腦中風致半身癱瘓合併反射交感性肌萎縮症候群三時相骨骼閃爍攝影與臨床特徵探討 |
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作 者 | 王鈺霖; 曹智超; 黃茂雄; 李碧芳; 李建宏; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷 期 | 14:1 1998.01[民87.01] |
頁 次 | 頁40-47 |
分類號 | 416.29 |
關鍵詞 | 腦中風致半身癱瘓; 反射交感性肌萎縮症候群; 三時相骨骼閃爍攝影; Cerebral vascular accident; Reflex sympathetic dystrophy; Three phase bone scintigraphy; |
語 文 | 英文(English) |
中文摘要 | 為研究腦中風致半身癱瘓上肢其三時相骨骼閃爍攝影及臨床反射交感性肌萎縮症候群的相關性,我們於復健科住院的病人中收集三十位經頭部電腦斷層證實診斷(出血型或梗塞型)為腦中風三個月內個案。所有病人在住院後均接受三時相骨骼閃爍攝影,在中風後至少追蹤三個月以上(平均268 ± 120天)以評估其患肢反射交感性肌萎縮症候群的發生情形。並對反射交感性肌萎縮症候群發展和有關的臨床表現(如:性別、年齡、患肢側別、中風病因及運動功能)的相關性作統計分析。共有十二位病人(40%)於追蹤期間以Tepperman氏標準判定有發生確定或可能反射交感性肌萎縮症候群。有十九位(63%)以中風三個月內(平均43 ± 25天)的延遲相骨骼閃爍攝影判定有反射交感性肌萎縮症候群証據。三時相骨骼閃爍攝影陽性延遲相造影檢查顯示靈敏度為92%;特異度為56%;正期望率為58%及負期望率為91%。卡方統計顯示陽性骨骼閃爍攝影和反射交感性肌萎縮症候群發生有70%的一致度(Kappa = 0.43 , p<0.05)。性別、年齡、患肢側別、中風病因及運動功能與臨床反射交感性肌萎縮症候群均無明顯相關性。總之,三時相骨骼閃爍攝影對半身癱瘓病患其反射交感性肌萎縮症候群發生為一實用的篩檢工具。然而,反射交感性肌萎縮症候群診斷仍屬臨床範疇,以三階段骨掃瞄作為輔助檢查仍需小心使用。 |
英文摘要 | In an attempt to investigate the correlation between three phase bone scintigraphy (TPBS) and the clinical manifestation of reflex sympathetic dystrophy symdrome (RSDS) in the upper extremity of hemiplegia, we collected 30 patients with cerebral vascular accidents (CVA) confirmed by head computed tomography (infarction or hemorrhage) within 3 months of their CVA event. All patients received TPBS after admission. Clinical assessment for the development of the RSDS was done at least 3 months (268± 120 days) after the stroke.The correlation between the development of RSD and certain clinical variables (including sex, age, side affected, cause of stroke, and motor stage) were analyzed. Twelve pateints (40%) manifestated definite or probable RSDS, as assessed by Tepperman¡¦s criteria, during the follow-up period. Nineteen patients (63 %) exhibited radlonuclide evidence of RSDS based on delayed bone scan criteria performed within 3 months (43± 25 days) of the stroke. The positive delayed image of TPBS demonstrated a sensltlvity=92%; speclficlty=56%; positive predictive value=58 %, and negative predictive value=91%. The Kappa statistics for agreement between positive bone scan and RSDS development was 70% (Kappa=0.43, p<0.05). Neither sex, age, side affected, cause of stroke, or motor stage had a significant correlation with clinical RSDS. In conclusion, TPBS is a useful screening tool for the development of RSD in hemiplegic patients. However, the diagnosis of RSDS depends on the clinical evaluation and that TPBS as an adjunct assessment of RSDS must be Interpreted with caution. |
本系統中英文摘要資訊取自各篇刊載內容。