CAJ | 학술논문

背景:格斯特曼综合征(Gerstmann syndrome,GS)临床少见,其康复治疗的临床研究报道较少,发病机制仍不清楚.目的:探讨GS的发病机制、临床特点及康复治疗.设计:以诊断为依据的回顾性分析.地点和对象:2003-04/2003-08复旦大学附属上海市第五人民医院住院治疗的2例GS患者.干预:采用常规治疗方法,一氧化碳中毒患者加用高压氧治疗.按GS四主征及失读、命名性失语给以康复治疗,时间3个月.主要观察指标:GS四主征及失读、命名性失语的评分情况.结果:GS多为脑血管病、肿瘤等所致,本文1例患者由一氧化碳中毒引起更为罕见,但头颅MRI显示大脑顶枕区有病灶,可能为缺氧所致.GS的四主征由于损害大脑顶枕区与身体、手指和数字空间定位独特性缺陷有关,但很少单独存在.GS的康复治疗有效,左右失认、手指失认相对恢复较好.结论:GS的病因、发病机制及康复治疗研究有十分重要意义.
배경:격사특만종합정(Gerstmann syndrome,GS)림상소견,기강복치료적림상연구보도교소,발병궤제잉불청초.목적:탐토GS적발병궤제、림상특점급강복치료.설계:이진단위의거적회고성분석.지점화대상:2003-04/2003-08복단대학부속상해시제오인민의원주원치료적2례GS환자.간예:채용상규치료방법,일양화탄중독환자가용고압양치료.안GS사주정급실독、명명성실어급이강복치료,시간3개월.주요관찰지표:GS사주정급실독、명명성실어적평분정황.결과:GS다위뇌혈관병、종류등소치,본문1례환자유일양화탄중독인기경위한견,단두로MRI현시대뇌정침구유병조,가능위결양소치.GS적사주정유우손해대뇌정침구여신체、수지화수자공간정위독특성결함유관,단흔소단독존재.GS적강복치료유효,좌우실인、수지실인상대회복교호.결론:GS적병인、발병궤제급강복치료연구유십분중요의의.
BACKGROUND: Gerstmann syndrome(GS), whose pathogenesis remainsunknown, is clinically rare and currently few reports are available to addressits rehabilitation.OBJECTIVE: To explore the pathogenesis, clinical features and rehabilita-tion of GS.DESIGN: A retrospective clinical study on the basis of diagnosis.SETTING and SUBJECTS: Two patients diagnosed as having GS were studied, who were hospitalized from April to August in 2003 in Shanghai Fifth People's Hospital affiliated to Fudan University.INTERVENTION: Routine therapeutic regimen was adopted, and one of the patients with CO poisoning also received hyperbaric oxygen therapy. Both of the two patients received rehabilitative training for 3 months for the 4 major symptoms of GS, alexia and nominal aphasia.MAIN OUTCOME MEASURES: The patients were scored for the 4 majorsymptoms, alexia and nominal aphasia.RESULTS: GS was most often caused by cerebrovascular disease and neoplasms, but GS caused by CO poisoning, as was the case with one of the patients, was rare. Skull magnetic resonance imaging(MRI) of this patient identified parietal-occipital lesions, which suggested the involvement of hypoxia in the pathogenesis of GS. The 4 major symptoms of GS were considered to involve parietal-occipital impairment that was responsible for spatial orientation defects of the body, finger and figures, which often appeared with one another. Rehabilitative training proved to be effective, especially for left-right disorientation and finger agnosia.CONCLUSION: Researches on the etiology, pathogenesis and rehabilitation can be of great significance for patients with GS.