| 岳月红,宋为群,胡 洁,霍 速,戴 洁.右侧脑损伤后左侧空间忽略的临床分型研究[J].中国康复医学杂志,2011,26(1):13~19 |
| 右侧脑损伤后左侧空间忽略的临床分型研究 点此下载全文 |
| 岳月红 宋为群 胡 洁 霍 速 戴 洁 |
| 首都医科大学宣武医院康复医学科，100053 |
| 基金项目：国家自然科学基金（30540058, 30770714）；北京市自然科学基金（7052030）；北京市委组织部优秀人才基金；北京市科技计划项目（Z0005187040191-1）资助；首都医学发展科研基金（2007-2068） |
| DOI： |
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| 摘要： |
| 摘要
目的：对右侧脑损伤后左侧空间忽略按表现的参考框架不同进行分型研究，并分析其临床特征。
方法：对于首次发生右侧半球脑损伤的患者176例，运用线段划消、星型划消、线段二等分、画钟测验及句子阅读进行忽略的筛查测验，并运用缺口探查和场景临摹测试对忽略患者进行不同参考框架下分型研究，进一步比较不同参考框架下忽略组间的一般状况、临床特征及忽略程度。
结果：在176例患者中，29例表现为左侧空间忽略，其中16例为单纯的自我为中心的忽略，13例合并存在自我为中心的忽略及刺激物为中心的忽略。单纯的自我为中心的忽略组与合并存在刺激物为中心的忽略组间的一般状况（年龄、性别构成比、MMSE），忽略程度（线段划消、星形划消、线段二等分、画钟及场景临摹）及临床特征（左侧肢体肌力、面瘫有无、偏盲有无、左侧躯体感觉异常、病理征有无）无显著的差异；合并刺激物为中心的忽略组的患者受教育年数明显高于单纯的自我为中心的忽略组。两组间的病灶分布无显著性差异。
结论：按参考框架的不同对左侧空间忽略进行分型，单纯的自我为中心的忽略最常见，但是近一半的自我为中心的忽略合并刺激物为中心的忽略。忽略的严重程度及躯体功能障碍的严重程度对忽略的分型无提示意义。受教育年限越长的右侧半球损伤的患者越容易存在非自我为中心的空间忽略。 |
| 关键词：偏侧空间忽略 参考框架 分型 |
| Clinical typing for left spatial neglect after right brain injury Download Fulltext |
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| Dept. of Rehabilitation Medicine, Xuanwu Hospital of Capital Medical University |
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| Abstract: |
| Abstract
Objective: To type left spatial neglect after right brain injury according to different reference frameworks and investigate their clinical features.
Method: One hundred and seventy-six patients with firstly right hemisphere injury were recruited. They all received neglect tests including line cancellation, star cancellation, line bisection, clock drawing, sentence reading, gap detection and scene copying, and then were typed according with the results of gap detection and scene copying. Clinic features of different groups were analyzed.
Result: Among 176 patients with right hemisphere injury, 29 patients manifested left spatial neglect, with 16 of egocentric left spatial neglect and 13 of both egocentric and stimulus-centered left spatial neglect. There were nonsignificant different in clinical features (myodynamia of left limbs, facial palsy, hemianopia, parethesia of left limbs and Babinski sign） and general status (age, sex, MMSE) between egocentric neglect group and combined stimulus-centered and egocentric neglect group. The differences were not significant in some neglect tests (line cancellation, star cancellation, line bisection, clock drowing and scene copying). However, compared with those of egocentric neglect group, the patients′ schooling years were much longer in the combined stimulus-centered and egocentric neglect group. The distributions of lesions were not different between the two groups.
Conclusion: In typing left spatial neglects of different reference frames, egocentric neglects were most common, almost half of which yet were combined with allocentric neglect. The severity of spatial neglect and body functionally impairment was nonpredictive in the types of spatial neglect according reference frames. Right hemisphere injuried patients with longer schooling years were tended to develop allocentric neglect. |
| Keywords:hemispatial neglect reference framework type |
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