脑卒中后假性球麻痹157例临床分析

Clinical management and therapeutic strategy for patients with pseudobulbar paralysis post stroke

目的 探讨脑卒中后假性球麻痹患者的临床管理及治疗策略.方法 回顾性分析157例康复期脑卒中患者的临床资料,筛选出并发假性球麻痹病例,并对所筛选病例的流行病学特征及治疗效果进行分析.结果 157例患者中并发假性球麻痹病例55例（35.0%）,其中出血性卒中26例（26/55,47.3%）,包括基底节区出血6例（6/26,23.0%）,小脑出血12例（12/26,46.2%）及脑干出血8例（8/26,30.8%）;缺血性卒中29例（29/55,52.7%）,其中皮质梗死9例（9/29,31.0%）,脑干梗死13例（13/29,44.8%）,小脑梗死7（7/29,24.2%）;多发病灶32例（32/55,58.2%）,单一病灶23例（23/55,41.8%）.55例假性球麻痹患者中,显效41例（42/55,76.4%）,有效11例（11/55,20.0%）,无效2例（2/55,3.6%）.结论 采取综合的管理措施及适合的内科治疗可能是针对脑卒中后假性球麻痹患者合理的临床管理及治疗策略.

Objective To investigate the clinical management and therapeutic strategy for patients with pseudobulbar paralysis post stroke. Methods To retrospectively analyze the clinical data of 157 patients poststroke whom were in convalescence stage. Then patients with pseudobulbar paralysis were selected and whose epidemiology feature and treatment effect were analyzed. Results In 157 patients,55 patients（35.0%） were complicated with pseudobulbar paralysis,among whom,26 patients（26/55,47.3%） with hemorrhagic stroke,including basal ganglia hemorrhage 6（6/26,23. 0%） , cerebellar hemorrhage 12 （12/26,46. 2%） and brain stem hemorrhage 8 （8/26,30. 8%）.29 patients suffered ischemic stroke（29/55,52.7%） ,including 9 cases with corticalis（9/29,31.0%）,13 with brain stem infarction（13/29,44.8%） and 7 with cerebellar infarction（7/29,24. 2%）. Among all the patients,32（32/55,58.2%） cases lesion were multiple and 23 cases（23/55,41. 8%） were simple. In the field of treatment effect of all patients,41 cases（42/55,76.4%） were with excellence, 11 with utility（11/55,20%） and 2 with inefficiency （2/55,3.6%）. Conclusion The comprehensive management and compatible medical treatment should be the compatible clinical management and therapeutic strategy for patients with pseudobulbar paralysis post stroke.