背景:Trousseau综合征患者,晚期癌症的常见并发症,通常生存不佳。出于这个原因,有必要确定康复治疗的有效性,并比一般卒中人群更早制定综合治疗策略。我们调查了Trousseau综合征患者开始强化康复治疗后1个月的身体功能与其结局之间的关系,以获得见解,以确定这些患者的强化康复指征。
方法:Trousseau综合征的发展可能会使表现状态(PS)恶化,通常需要重新评估原发癌的治疗适应症。此外,原发癌可能在康复治疗期间进展。
方法:这些患者被诊断为Trousseau综合征。
方法:所有患者每天在治疗师的监督下接受2至3小时的培训,每周7天,专注于运动疗法。入院康复病房1个月后的功能独立性测量(FIM),入院时和上次评估日期的改良Rankin量表(MRS)得分,并对其结果进行了检查。
结果:从中风发作到入院到康复的时间为22到60天。原发性癌症是肺癌,膀胱,前列腺,卵巢,子宫,未知的主要。4例晚期癌症伴远处转移。2例患者出院回家,具有独立的日常生活活动(ADL)状态。两名患者被转移到姑息治疗,3名患者死亡。2例具有独立ADL状态的患者在FIM上的平均运动评分为90,平均认知评分为30,而其他5例患者在入院1个月时的平均运动评分为29分,平均认知评分为21分。入院时mRS>3的患者在1个月时没有独立的ADL状态。
结论:特鲁索综合征患者在康复约1个月后有望改善身体功能。如果恢复不充分,应考虑姑息治疗。
BACKGROUND: Patients with Trousseau syndrome, a common complication of advanced cancer, typically have poor survival. For that reason, there is a need to determine the effectiveness of rehabilitation treatment and develop a comprehensive treatment strategy earlier than that in the general stroke population. We investigated the relationship between physical function and its outcome 1 month after the start of intensive rehabilitation treatment in patients with Trousseau syndrome, to obtain insights for determining the indications for intensive rehabilitation in these patients.
METHODS: The development of Trousseau syndrome may worsen the performance status (PS), often necessitating a reevaluation of the indications for treatment of the primary cancer. Furthermore, the primary cancer may progress during rehabilitation therapy.
METHODS: These patients were diagnosed with Trousseau syndrome.
METHODS: All patients underwent training under the supervision of a therapist for 2 to 3 hours per day, 7 days per week, with a focus on exercise therapy. The functional independence measure (FIM) 1 month after admission to the convalescent rehabilitation ward, modified Rankin scale (mRS) score on admission and on the date of last assessment, and its outcome was examined.
RESULTS: The time from stroke onset to admission to rehabilitation ranged from 22 to 60 days. Primary cancers were lung, bladder, prostate, ovarian, uterine, and unknown primary. Four patients had advanced cancer with distant metastasis. Two patients were discharged to home with independent activities of daily living (ADL) status. Two patients were transferred to palliative care, and 3 patients died. The 2 patients with independent ADL status had a mean motor score of 90 and a mean cognitive score of 30 on FIM, while the other 5 patients had a mean motor score of 29 and a mean cognitive score of 21 at 1 month of admission. Patients with mRS > 3 on admission did not have independent ADL status at 1 month.
CONCLUSIONS: Intensive rehabilitation therapy may be indicated for patients with Trousseau syndrome who are expected to improve physical function after approximately 1 month of rehabilitation. Palliative care should be considered if recovery is inadequate.