{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T07:20:47Z","timestamp":1697700047462},"reference-count":25,"publisher":"Akademiai Kiado Zrt.","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,1,1]]},"abstract":"<jats:p>Baleset vagy betegs\u00e9g k\u00f6vetkezt\u00e9ben az emberi szervezetet \u00e9r\u0151 primer k\u00e1rosod\u00e1sok (agys\u00e9r\u00fcl\u00e9s) mellett a m\u00e1sodlagos k\u00e1rosod\u00e1sok hat\u00e1rozz\u00e1k meg a p\u00e1ciens helyre\u00e1ll\u00edt\u00e1s\u00e1nak lehet\u0151s\u00e9g\u00e9t, a rehabilit\u00e1ci\u00f3 sor\u00e1n el\u00e9rhet\u0151 maxim\u00e1lis funkcion\u00e1lis \u00e1llapotot \u00e9s a k\u00e9s\u0151bbiekben a beteg \u00e9letmin\u0151s\u00e9g\u00e9t. Ez\u00e9rt az eg\u00e9szs\u00e9g\u00fcgyi ell\u00e1t\u00e1s sor\u00e1n a m\u00e1sodlagos k\u00e1rosod\u00e1sok kialakul\u00e1s\u00e1nak megakad\u00e1lyoz\u00e1sa legal\u00e1bb olyan jelent\u0151s\u00e9g\u0171, mint a primer prevenci\u00f3. \n <jats:italic>C\u00e9lkit\u0171z\u00e9sek:<\/jats:italic>\n A s\u00falyos agys\u00e9r\u00fcl\u00e9st k\u00f6vet\u0151en kialakul\u00f3 legfontosabb m\u00e1sodlagos k\u00e1rosod\u00e1sok meghat\u00e1roz\u00e1sa, ezek rehabilit\u00e1ci\u00f3t befoly\u00e1sol\u00f3 hat\u00e1s\u00e1nak vizsg\u00e1lata. \n <jats:italic>M\u00f3dszer:<\/jats:italic>\n Retrospekt\u00edv vizsg\u00e1lat az Orsz\u00e1gos Orvosi Rehabilit\u00e1ci\u00f3s Int\u00e9zet Koponyaagy-s\u00e9r\u00fcltek Rehabilit\u00e1ci\u00f3s Oszt\u00e1ly\u00e1n. \n <jats:italic>Eredm\u00e9nyek:<\/jats:italic>\n A 2004. \u00e9v folyam\u00e1n kezelt 166, baleset k\u00f6vetkezt\u00e9ben s\u00falyos agyk\u00e1rosod\u00e1st szenvedett p\u00e1ciens \u00e1tlag\u00e9letkora 33 \u00e9v (8\u201383) volt. A betegek t\u00f6bbs\u00e9ge (125\/166) k\u00f6zleked\u00e9si balesetben s\u00e9r\u00fclt meg, a t\u00f6bbiek magasb\u00f3l es\u00e9s, vereked\u00e9s, l\u00f6v\u00e9s vagy robban\u00e1s k\u00f6vetkezt\u00e9ben. Az intenz\u00edv oszt\u00e1lyr\u00f3l k\u00f6zvetlen\u00fcl 64, m\u00e1sodik helyr\u0151l (p\u00e9ld\u00e1ul: traumatol\u00f3gia, idegseb\u00e9szet vagy neurol\u00f3gia) 18 beteget vett\u00fcnk \u00e1t. A balesett\u0151l sz\u00e1molva \u00e1tlagosan az 50. (21\u2013177.) napon vett\u00fck \u00e1t a betegeket rehabilit\u00e1ci\u00f3ra. Felv\u00e9telkor 83 beteg hemipareticus, 54 tetra-, 1 parapareticus volt, m\u00edg 28 betegn\u00e9l nem \u00e9szlelt\u00fcnk paresist. Huszonh\u00e9t beteget vegetat\u00edv, 38-at pedig minim\u00e1lisan tudatos \u00e1llapotban vett\u00fcnk fel. A\u00a0s\u00falyos agys\u00e9r\u00fclt betegek felv\u00e9telekor \u00e9szlelt \u00e9s a rehabilit\u00e1ci\u00f3 sor\u00e1n kezelt leggyakoribb sz\u00f6v\u0151dm\u00e9nyek: \u00edz\u00fcleti contractura (47%), decubitus (35%), l\u00e9g\u00fati (14%) \u00e9s h\u00fagy\u00fati (11%) infekci\u00f3k, heterotop ossificatio (17%), alult\u00e1pl\u00e1lts\u00e1g (20%). A rehabilit\u00e1ci\u00f3 sor\u00e1n a sz\u00f6v\u0151dm\u00e9nyes esetekben az \u00f6nell\u00e1t\u00e1s ter\u00e9n azonos \u00e1pol\u00e1si id\u0151 alatt rosszabb funkcion\u00e1lis eredm\u00e9nyeket \u00e9rt\u00fcnk el, \u00e9s az \u00e1pol\u00e1si id\u0151 is jelent\u0151s m\u00e9rt\u00e9kben meghosszabbodott. \n <jats:italic>K\u00f6vetkeztet\u00e9sek:<\/jats:italic>\n A sz\u00f6v\u0151dm\u00e9nyek kialakul\u00e1s\u00e1nak megakad\u00e1lyoz\u00e1s\u00e1ra ir\u00e1nyul\u00f3 tev\u00e9kenys\u00e9geket m\u00e1r a primer ell\u00e1t\u00f3helyen meg kell kezdeni. Az akut ell\u00e1t\u00e1s ut\u00e1n a t\u00f6bbsz\u00f6r\u00f6s funkci\u00f3k\u00e1rosodott (motoros, kognit\u00edv, kommunik\u00e1ci\u00f3s, pszichoszoci\u00e1lis probl\u00e9m\u00e1k) s\u00falyos agys\u00e9r\u00fclt betegek rehabilit\u00e1ci\u00f3j\u00e1t centrumokban \u00e9rdemes v\u00e9gezni, ahol ilyen betegek ell\u00e1t\u00e1s\u00e1ra specializ\u00e1l\u00f3dott teamek dolgoznak. Optim\u00e1lis megold\u00e1s, ha a neurointenz\u00edv oszt\u00e1lyokr\u00f3l vagy az akut oszt\u00e1lyokr\u00f3l min\u00e9l kor\u00e1bban \u00e9s k\u00f6zvetlen\u00fcl a rehabilit\u00e1ci\u00f3s oszt\u00e1lyokra ker\u00fclnek a betegek, \u00edgy a m\u00e1sodlagos k\u00e1rosod\u00e1sok kialakul\u00e1s\u00e1nak lehet\u0151s\u00e9ge jelent\u0151sen cs\u00f6kkenhet.<\/jats:p>","DOI":"10.1556\/oh.2009.28357","type":"journal-article","created":{"date-parts":[[2009,1,15]],"date-time":"2009-01-15T03:51:02Z","timestamp":1231991462000},"page":"165-169","source":"Crossref","is-referenced-by-count":7,"title":["Consequence of secondary complications during the rehabilitation of patients with severe brain injury"],"prefix":"10.1556","volume":"150","author":[{"given":"Zolt\u00e1n","family":"D\u00e9nes","sequence":"first","affiliation":[{"name":"1 Orsz\u00e1gos Orvosi Rehabilit\u00e1ci\u00f3s Int\u00e9zet Koponyaagy-s\u00e9r\u00fcltek Rehabilit\u00e1ci\u00f3s Oszt\u00e1lya Budapest Szanat\u00f3rium u. 19. 1121"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"atypb1","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1001\/jama.282.10.974","volume":"282","year":"1999","journal-title":"JAMA"},{"key":"atypb2","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1097\/01.PHM.0000154896.55045.E7","volume":"84","year":"2005","journal-title":"Am. 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