最少意识状态加与减:出现和长期功能独立的可能性
Roberto Llorens1, Camilla Ippoliti2, María Dolores Navarro3
1Neurorehabilitation and Brain Research Group, Universitat Politècnica de València, València, Spain.
Annals of clinical and translational neurology
|February 17, 2024
概括
患有最小意识状态加 (MCS+) 的人比患有最小意识状态减 (MCS-) 的人更有可能出现意识障碍. 然而,出现后的功能独立性在两组中都是相似的.
科学领域:
- 神经科学是一个神经科学.
- 康复医学 康复医学 康复医学
- 临床神经学 临床神经学
背景情况:
- 意识障碍,包括最小意识状态 (MCS),在神经康复中存在重大挑战.
- 将MCS分为MCS-Plus (MCS+) 和MCS-Minus (MCS-) 的分类旨在完善预后理解,但临床有效性需要进一步调查.
- 了解出现和功能结果的预测因素对于患者护理和治疗策略至关重要.
研究的目的:
- 为了比较MCS+和MCS-.分类为MCS的个体之间的MCS出现的可能性和时间.
- 评估和比较最初被归类为MCS+与MCS-的个体在出现后6个月的功能独立性.
主要方法:
- 从80名参与者 (30MCS+,50MCS-) 在神经康复单位的人口和行为数据的回顾性分析.
- 每周进行神经行为评估,直到出院,死亡或从MCS中出现.
- 在出现后6个月对那些出现的人进行功能独立性评估.
主要成果:
- 所有被归类为MCS+的参与者都从MCS中出现,与MCS-参与者相比,出现的时间更短.
- 大约50%的MCS参与者从MCS中出来.
- 尽管出现率和时间有差异,但在出现后6个月的功能独立性是可比的,并表明了两组人的高残疾.
结论:
- 与MCS-.相比,MCS+分类与意识障碍的更高概率和更快的出现有关.
- 最初分类为MCS+或MCS-并不能预测出现6个月后的功能独立性.
- 这些发现支持MCS分类的预后价值,对出现但不是长期功能结果.
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