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目的了解脑血管病所致脑损伤后近体空间忽视的发生率、忽视组脑损伤部位的分布及偏盲的发生情况,探讨忽视的临床表现特点及其机制。方法应用划消试验、临摹画图、自发画图、行为测查以及视野计对73例临床确诊的单侧脑损伤患者进行忽视筛查、视野检查,并对其损伤部位进行分析。结果在发病后3周评估,忽视的发生率为28.8%,其中右大脑半球忽视的发生率为40.0%,左大脑半球忽视的发生率为15.2%(P<0.01);发病后6周评估,忽视的发生率为19.2%,其中右大脑半球忽视的发生率为32.5%,左大脑半球忽视的发生率为3.03%(P<0.01)。忽视组:涉及顶叶占61.9.5%,颞叶占52.4%,额叶占23.8%,枕叶占23.8%,基底节占19.0%,丘脑占14.3%,岛叶占9.52%,扣带回占4.76%。忽视组偏盲的发生率为52.3%,非忽视偏盲的发生率为11.5%(P<0.01)。右大脑半球忽视程度较左大脑半球严重、持久,且非表现绝对偏侧忽视。结论空间忽视发生率主要受评估的方法和评估的时间影响,右大脑半球忽视的发生率高于左大脑半球;忽视组脑损伤部位主要见于顶叶、颞叶,忽视组偏盲的发生率高于非忽视组。忽视的机制可能为空间一侧成分缺陷和非一侧成分缺陷交互作用而产生。
Objective To understand the incidence of cerebrovascular disease-induced near-brain spatial neglect, ignoring the distribution of brain injury sites and the incidence of hemianopia, to explore the characteristics of neglected clinical manifestations and its mechanism. Methods A total of 73 patients with unilateral brain injury diagnosed as neglected screening and visual field examination were screened with delineation test, copy-drawing test, spontaneous drawing test, behavioral test and visual field test, and their injury sites were analyzed. Results The incidence of omission was 28.8% at 3 weeks after onset. The incidence of neglect in the right hemisphere was 40.0% and that in the left hemisphere was 15.2% (P <0.01). Six weeks after the onset of disease, The incidence of neglect was 19.2%. The incidence of neglect in the right hemisphere was 32.5% and that in the left hemisphere was 3.03% (P <0.01). Neglect group: involving the top of the leaves accounted for 61.9.5%, temporal lobe accounted for 52.4%, frontal 23.8%, occipital 23.8%, basal ganglia 19.0%, thalamic 14.3%, island leaves 9.52%, cingulate Accounting for 4.76%. The incidence of hemianopia in the neglected group was 52.3%, and the incidence of non-neglected hemianopia was 11.5% (P <0.01). The degree of neglect of the right hemisphere than the left hemisphere is serious, lasting, and non-performance is absolutely neglected. Conclusions The incidence of spatial neglect is mainly affected by the method of evaluation and the time of evaluation. The incidence of neglect in the right hemisphere is higher than that in the left hemisphere. The incidence of hemianopia in the neglected group is higher than that in the parietal lobe, temporal lobe, and neglected group Non-neglected group. Negligible mechanisms may result from the interaction of structural defects and non-structural defects on one side of the space.