目的 探讨高压氧治疗(HBOT)烟雾病(MMD)患者的疗效及安全性因素.方法 回顾性分析南京紫金医院2020 年1 月—2021 年12 月收治的26 例MMD患者的临床资料,分析指标主要包括年龄、发病时长、血压、HBOT次数及压力、原发病情况、手术方式、入院及出院意识状态、肢体功能及有无不良脑血管病事件等.结果 入组患者平均年龄(45.2±15.2)岁,大多在发病 1 个月内来院治疗;大部分患者入院时血压波动于正常范围,少数患者血压有波动,经治疗后稳定;26 例患者中,13 例为缺血型 MMD,13 例为出血型MMD;26 例患者中,21 例行高压氧治疗 20～60 次,60 次以上者 5 例;高压氧治疗压力以 1.6 ATA或 1.6/2.0 ATA为主.治疗过程及治疗结束未见再出血及再次梗塞等脑血管事件发生.26 例患者中,21 例明显好转,4 例好转,1 例无变化.结论 儿童及成人缺血型、出血型MMD患者均可行高压氧治疗,尤其在行颅内外血运重建术及血肿清除术等手术后,高压氧治疗过程中未见再出血、再梗塞等不良脑血管病事件,提示安全性较高.在高压氧治疗前及过程中须控制患者的血压、颅内压等情况,可给予不同压力治疗方案.

Objective:To discuss the quantitative evaluation of the consciousness state in patients with primary brainstem stroke（PBS）and the correlation between the hyperbaric oxygen（HBO）therapy and the outcomes of PBS patients.Methods:A total of 54 PBS patients admitted to Nanjing Zijin Hospital for comprehensive HBO treatment from January 2020 to June 2021 were selected，according to the exclusion criteria that the patient should not have central nerve injuries outside the brainstem，metabolism disorders，or on medication that may affect their consciousness states. According to stroke volume，the 54 subjects were divided into three groups：<6 ml，6-10 ml，and >10 ml. According to stroke location，they were divided into four groups：midbrain，pons，midbrain-to-pons，and medulla oblongata. The Chinese Nanjing Persistent Vegetative State Scale（CNPVSS）score of each patient was measured. The consciousness states of the patients before discharge and at admission were compared between groups of different stroke volumes and stroke locations，and the influencing factors of outcome and their correlations with outcomes were explored.Results:The CNPVSS scores of all patients was 7（1，17）at admission and 13（3，19）before discharge，and the difference was statistically significant（ P<0.01）. Consciousness states differed significantly among groups with different brainstem stroke volumes，both at admission and before discharge（ P<0.01），but there was no significant difference in consciousness states among groups with different stroke locations（ P>0.05）. The CNPVSS score was positively correlated with the times of HBO therapy（ P=0.040），and negatively correlated with the stroke volume（ P<0.05）. Conclusion:The CNPVSS can be used to quantitatively evaluate the consciousness state of the patients with brainstem stroke. The effect of brainstem stroke volume on the consciousness states was greater than that of stroke location. HBO therapy may be a positive factor in improving the consciousness states in patients with brainstem stroke.

我国老一辈脑复苏领域专家编制的中国南京持续性植物状态量表（CNPVSS）在临床应用已有20余年。20多年来随着人们对意识障碍的深入研究，其概念也在不断发生变化，对该量表的解读也在临床研究中不断完善。同时工作中也存在着初学者不能正确理解和运用量表，量表的命名和某些子项目的描述需进一步修订等问题。笔者根据多年来大量意识障碍患者临床病例的量表应用经验，结合国内外有关意识障碍的研究成果，提出了量表的操作方法和结果解读方案，也提出了修订建议，供同行及相关专家评议。

目的:体会高压氧治疗急性脑梗死的临床价值.方法:遵从"平衡序贯法"分组,择我院2019.6-2020.4内80例急性脑梗死患者分为对照组(35例,常规治疗)和观察组(45例,雷联高压氧);观察临床疗效.结果:临床疗效分析:观察组高达93.33％,对照组为77.14％,P<0.05.经治疗后观察组患者巨噬细胞集落刺激因子等指标水平较低,P<0.05.结论:高压氧治疗急性脑梗死效果显著,可有效提高临床疗效并改善患者血清指标.