广西医学

目的　探讨高压氧联合滚筒作业训练在脑卒中偏瘫患者中的应用效果。方法　选取116例脑卒中偏瘫患者作为研究对象，随机分为观察组与对照组，各58例。对照组患者采用滚筒作业训练，观察组患者采用高压氧联合滚筒作业训练治疗。比较两组患者治疗前及治疗2个月后的神经功能［美国国立卫生研究院卒中量表（NIHSS）评分］、生活自理能力［巴氏指数（BI）评定表评分］、运动功能［Fugl⁃Meyer运动功能评分量表（FMA）评分、运动功能状态量表（MSS）评分、Berg平衡量表（BBS）评分、10 m最大步行速度（10 m MWS）］，并对两组患者进行步态分析，观察两组患者治疗期间不良反应发生情况。结果　治疗后，两组患者的NIHSS评分、双腿支撑期较治疗前下降，且观察组的上述指标低于对照组（P<0.05）；两组患者的BI评定表评分、上肢FMA评分、下肢FMA评分、MSS评分、BBS评分、10 m MWS、步频、步幅、患侧步长、步态周期均高于或大于治疗前，且观察组的上述指标均高于或大于对照组（P<0.05）。两组患者治疗期间不良反应发生率差异无统计学意义（P>0.05）。结论高压氧治疗联合滚筒作业训练可改善脑卒中偏瘫患者的神经功能，提高患者的生活自理能力及运动能力，纠正步态，效果优于单用滚筒作业训练，且安全性较高。

Objective To explore the application effect of hyperbaric oxygen combined with roller operation training in patients with hemiplegia after cerebral stroke. Methods A total of 116 patients with hemiplegia after cerebral stroke were selected as the research subjects, and they were randomly divided into observation group or control group, with 58 cases in each group. The control group received roller operation training, while the observation group received hyperbaric oxygen combined with roller operation training therapy. The neurological function in terms of National Institutes of Health Stroke Scale (NIHSS) score, self⁃care ability of daily living with respect to Barthel index (BI) assessment score, motor function concerning Fugl⁃Meyer Assessment (FMA) score, Motor Status Scale (MSS) score, Berg Balance Scale (BBS) score, and 10⁃meter maximum walking speed (10 m MWS) before treatment and 2 months after treatment were compared between the two groups. Gait analysis was performed in the two groups. The occurrence status of adverse reactions during treatment was compared between the two groups. Results After treatment, the NIHSS score and leg support period of the two groups were lower than those before treatment, and the aforementioned indices in the observation group were lower than those in the control group (P<0.05). The BI assessment score, FMA score of upper limb, FMA score of lower limb, MSS score, BBS score, 10 m MWS, stride frequency, stride length, stride length on the affected side and gait cycle of the two groups were higher or greater than those before treatment, and the indices as above in the observation group were higher or greater than those in the control group (P<0.05). There was no statistically significant difference in the incidence rate of adverse reactions between the two groups during treatment (P>0.05). Conclusion Hyperbaric oxygen combined with roller operation training can ameliorate the neurological function of patients with hemiplegia after cerebral stroke, improve the self-care ability and motor ability of patients, and correct the gait. The effect is better than the single roller operation training, exerting favorably high safety.