作者：易琼，孙文琳，祁玉军

单位：

223300江苏省淮安市，南京医科大学附属淮安第一医院康复科

Units：

Rehabilitation Department, the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian 223300, China

关键词：

卒中；单侧空间忽略；经颅直流电刺激；高压氧疗；治疗结果

Keywords：

Stroke; Unilateral spatial neglect; Cranial direct current stimulation; Hyperbaric oxygen therapy; Treatment outcome

CLC：

R 743

DOI：

10.12114/j.issn.1008-5971.2022.00.043

Funds：

摘要：

背景　研究表明，经颅直流电刺激能有效改善单侧空间忽略患者的运动功能和认知功能，但临床上 对经颅直流电刺激联合高压氧疗治疗脑卒中后单侧空间忽略患者的临床效果尚不明确。目的　观察经颅直流电刺激联 合高压氧疗治疗脑卒中后单侧空间忽略患者的临床效果。方法　选取2015年9月至2021年2月南京医科大学附属淮安第 一医院收治的82例脑卒中后单侧空间忽略患者为研究对象，采用随机数字表法分为对照组和联合组，每组41例。对照 组患者采用高压氧疗治疗，联合组患者采用经颅直流电刺激联合高压氧疗治疗；两组患者均连续治疗4周。比较两组 患者治疗前后画钟实验、线段等分实验（LBT）及Albert线段划消实验评分，临床疗效，治疗前后简式Fugl-Meyer运动 功能评分法（FMA）评分、改良Barthel指数（MBI）评分及简易精神状态检查量表（MMSE）评分。结果　治疗后， 对照组和联合组患者画钟实验、LBT及线段划消实验评分分别低于本组治疗前，且联合组患者画钟实验、LBT及线段 划消实验评分低于对照组（P ＜0.05）。联合组患者临床疗效优于对照组（P ＜0.05）。治疗后，对照组和联合组患者 FMA评分、MBI评分及MMSE评分分别高于本组治疗前，且联合组患者FMA评分、MBI评分及MMSE评分高于对照组（P ＜0.05）。结论　经颅直流电刺激联合高压氧疗治疗脑卒中后单侧空间忽略患者可提高其临床疗效，促进运动功能康 复，提高日常生活活动能力及认知功能，值得在临床上推广应用。

Abstract：

Background　Studies have shown that transcranial direct current stimulation can effectively improve the motor function and cognitive function in patients with unilateral spatial neglect, but the clinical effect of transcranial direct current stimulation combined with hyperbaric oxygen therapy in the treatment of patients with unilateral spatial neglect after stroke is not clear. Objective　To observe the clinical effect of combined treatment of transcranial direct current stimulation and hyperbaric oxygen therapy on unilateral spatial neglect after stroke. Methods　A total of 82 patients with unilateral spatial neglect after stroke treated in the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University from September 2015 to February 2021 were selected as the research objects. They were divided into control group and combined group according to random number table method, with 41 cases in each group. The patients in the control group were treated with hyperbaric oxygen therapy, and the patients in the combined group were treated with transcranial direct current stimulation combined with hyperbaric oxygen therapy; both groups were treated for 4 weeks. The scores of Clock Drawing Test, Line Bisection Test (LBT) and Albert Line Segment Cancellation Test before and after treatment, clinical efficacy, the scores of Fugl-Meyer Movement Function (FMA) , modified Barthel Index (MBI) and Minimental Status Examination (MMSE) before and after treatment were compared between the two groups. Results　After treatment, the scores of Clock Drawing Test, LBT and Albert Line Segment Cancellation Test in the control group and the combined group werelower than those before treatment, respectively, and the scores of Clock Drawing Test, LBT and Albert Line Segment Cancellation Test in the combined group were lower than those in the control group (P < 0.05) . The clinical effect of the combined group was better than that of the control group (P < 0.05) . After treatment, the scores of FMA, MBI and MMSE in the control group and the combined group were higher than those before treatment, respectively, and the scores of FMA, MBI and MMSE in the combined group were higher than those in the control group (P < 0.05) . Conclusion　Transcranial direct current stimulation combined with hyperbaric oxygen therapy in the treatment of patients with unilateral spatial neglect after stroke can improve their clinical efficacy, promote the rehabilitation of motor function, and improve the ability of activities of daily living and cognitive function. It is worthy of clinical application.

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