肺塞栓を合併した左被殻出血のリハビリテーション 症例報告

Abstract

Pulmonary embolism and deep vein thrombosis are believed to be rare in Japan, whereas, they are an important cause of death in stroke patients in Europe or United States. However, a few studies have warned that incidences of them are underestimated in Japan. A 57-year-old woman with acute putaminal hemorrhage admitted to our hospital 11 days after stroke, and intensive rehabilitation program was applicated. Before her admission to our hospital, she was admitted to another hospital and forced to have complete rest. She presented symptoms of hypoxia 19 days after stroke. She was diagnosed as having pulmonary embolism. Clinical findings of pain or swelling of the paralized leg were absent. Greenfield vena cava filter was implanted immediately after diagnosis, and mild anticoagulant therapy was also started. Physical therapy was practiced with the supply of oxigen under the cardiac, hemodynamometric and oximetric monitoring. These special consideration enabled her to be applied physical therapy more safely. When she was discharged home at 38 days after stroke, her activities of daily living had already improved to be independent. We consider that physical therapy including standing is good indication for acute stroke patients to prevent deep vein thrombosis or pulmonary embolism.