目的 观察上肢力反馈结合任务导向性训练对脑卒中偏瘫患者上肢功能和日常生活能力的影响.方法 35例脑卒中偏瘫患者随机分为治疗组(17例)和对照组(18例).对照组患者在常规康复治疗基础上采用传统作业治疗,每天1次,每次30 min,每周6次,共4周;治疗组在常规康复治疗和传统作业治疗基础上,运用上肢力反馈结合任务导向性训练,每天1次,每次20 min,每周6次,共4周.在治疗前后分别采用上肢Fugl-Meyer评定量表(FMA-UE)、上肢Brunnstrom分期、偏瘫手功能分级和改良Barthel指数(MBI)评估两组患者上肢运动功能和日常生活能力.结果 治疗后,两组患者的FMA-UE评分和MBI评分均较治疗前改善(P＜0.05),且治疗组改善更明显(P＜0.05).治疗后,治疗组患者上肢Brunnstrom分期和偏瘫手功能分级与对照组比较有统计学差异(P＜0.05).结论 上肢力反馈结合任务导向性训练能有效提高脑卒中偏瘫患者上肢运动功能和日常生活能力.

目的:探讨高压氧(hyperbaric oxygen，HBO)对颅内血肿清除术后阵发性交感神经过度兴奋综合征(paroxysmal sympathetic hyperactivity，PSH)的疗效。方法:对药物治疗难以控制症状发作的3例颅内血肿清除术后并发PSH的患者分别于术后第16、21、52天行HBO治疗，评价HBO对PSH的疗效以及患者的预后。结果:3例患者经3次HBO治疗，PSH症状明显缓解，临床症状量表(clinical feature scale，CFS)评分明显下降；经5~7次HBO治疗后，PSH症状完全消失。结论:HBO治疗对于药物难治的PSH患者具有良好的疗效，同时也可改善患者预后。

Objective:To evaluate the effect of early hyperbaric oxygen therapy (HBOT) on neurological function recovery of basal ganglia hemorrhage patients who didn’t receive hematoma evacuation.Methods:A total of 41 basal ganglia hemorrhage patients treated in Nanjing Zijin Hospital and PLA Air Force Hospital of The Eastern Theater Command from January 2015 to January 2020 were included in this study. They did not undergo hematoma evacuation surgery due to small hematoma volume, 18 of whom received early HBOT (treatment group), and the remaining 23 patients received the same HBOT two weeks after hemorrhage (control group). The hematoma volume and the changes of perihematomal edema (PHE) were observed using regular head CT scan, and the incidences of PHE expansion in the two groups were compared on the 10th day after the hemorrhage. All the 41 patients’ neurological functions were assessed by the National Institutes of Health stroke scale (NIHSS) and Glasgow outcome scale (GOS) upon their admission and three months after admission.Results:No re-hemorrhage was found in any patient on the head CT scan. On the 10th day after admission, the incidence of PHE expansion was 16.7% in the treatment group and 91.3% in the control group, respectively, the difference was statistically significant ( P<0.01). After three months of treatment, the NIHSS scores of both groups were decreased, and the GOS scores of both groups were increased. The NIHSS score of the treatment group was lower than that of the control group, while the GOS score in the treatment group was higher than that of the control group, both with statistically significant differences ( P<0.05). Conclusion:Early HBOT is a safe treatment for basal ganglia hemorrhage patients without hematoma evacuation, and it can reduce the occurrence of PHE and improve the prognosis of patients.

Objective:To investigate the effects of minimally invasive aspiration and drainage combined with hyperbaric oxygen (HBO) therapy on inflammatory factors and cerebrovascular dynamic indicators in patients with hypertensive intracerebral hemorrhage.Methods:A total of 74 patients with hypertensive intracerebral hemorrhage treated in 454 Hospital and Nanjing Zijin Hospital from January 2019 to January 2021 were selected and randomly divided into treatment group ( n=37) given minimally invasive aspiration and drainage combined with HBO therapy and control group ( n=37) given minimally invasive aspiration and drainage only. The levels of serum inflammatory factors, cerebrovascular dynamic indicators, arterial blood gas (ABG) levels, and the neurologic function scores in the two groups before and after treatment were compared. Results:Before treatment, there was no significant difference between the two groups in the levels of serum inflammatory factors, cerebrovascular dynamic indicators, ABG levels, and the neurological function scores ( P>0.05); after 30 days of treatment, the levels of inflammatory factors such as tumor necrosis factor-α (TNF-α), interleukin-1(IL-1), and IL-8 in the treatment group were lower than those in the control group, the National Institute of Health Stroke Scale (NIHSS) scores, the values of peripheral resistance (PR) and dynamic resistance (DR) in the treatment group were lower than those in the control group, while the Mini-mental State Examination (MMSE) scores, the mean blood flow velocities (Vm), mean blood flow quantities (Qm), the arterial partial pressures of CO 2 (PaCO 2) and the arterial partial pressures of oxygen (PaO 2), and the blood pH values in the treatment group were higher than those in the control group ( P<0.05), and all the differences were statistically significant ( P<0.05). Conclusion:Minimally invasive aspiration and drainage combined with HBO therapy in the treatment of hypertensive intracerebral hemorrhage can effectively reduce the patients’ inflammatory response and promote the recovery of cerebral vascular dynamics and nerve function.