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目的 探讨脑病变的部位及大小与Brunnstrom偏瘫阶段及痉挛程度的关系。方法 36例患者 ,男 2 6例 ,女 1 0例 ;年龄 1 6～ 70岁 ;左侧脑病变 1 7例 ,右侧 1 9例 ;脑血肿 1 7例 ,脑梗死及脑皮质软化灶 1 9例。结果 脑皮质受损部分患者呈跳跃式恢复 ,痉挛主要表现为不能伸腕、指及踝背屈障碍 ,当上肢伸肌功能恢复后 ,屈肌痉挛消失 ;顶叶受损 (病变体积为 30～ 50cm3)患者残留症状为不能并指、分指 ,对掌运动及踝自主背屈障碍 ;内囊部分病变患者主要表现为肢体远端痉挛 ,痉挛期与分离期重叠出现 ,即出现伸腕、指运动时 ,屈腕、指肌及屈拇长肌仍有痉挛现象存在 ;内囊大部分或完全病变患者 ,痉挛表现在四肢所有关节 ,运动功能恢复较差。结论 脑病变部位及大小不同 ,痉挛程度不同 ,痉挛程度与运动训练疗效关系密切 ,均有助于判断患者康复后期日常生活活动能力及运动功能恢复状况
Objective To investigate the relationship between the location and size of brain lesions and the stage of Brunnstrom hemiplegia and spasticity. Methods Thirty-six patients were enrolled in this study. There were 26 males and 10 females, aged from 16 to 70 years. There were 17 cases of left encephalopathy and 19 cases of right encephalocele. Seventeen cases of cerebral hematoma, cerebral infarction and cerebral cortex softening 1 9 cases. Results Patients with impaired cortical area showed leapfrog recovery. Spasm mainly manifested as no extension of the wrist, ankle dorsiflexion, and disappearance of flexor spasm after upper extremity extensor function was restored. The parietal lobe was damaged (the volume of lesion was 30 ~ 50cm3) patients with residual symptoms can not and refers to the finger, palmar movement and ankle dystonic disorder; part of the internal capsule lesions mainly for distal limb spasticity, spasm and separation overlap, that is, extensor wrist, finger Exercise, wrist flexor, finger muscle and flexor hallucis longus muscle spasm still exists; most of the internal capsule or patients with complete disease, spasm in all joints of the limbs, poor motor function recovery. Conclusions The brain lesion location and size are different, the degree of spasticity is different. The degree of spasticity is closely related to the effect of exercise training, all of which are helpful to judge the activity of daily living and recovery of motor function in the later stage of rehabilitation