早期高压氧综合治疗对颅内动脉瘤夹闭术后脑功能康复的影响  

Effects of hyperbaric oxygen therapy early after craniotomy on the rehabilitation of cerebral function in patients with intracranial aneurysms

作　　者：田家林[1] 张禹[2] 杨晨[2] 孟祥恩[2] 

机构地区：[1]广州军区武汉总医院康复理疗科,武汉430070 [2]海军总医院高压氧科,北京100037

出　　处：《中国临床神经外科杂志》2010年第11期657-660,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨早期高压氧综合治疗对颅内动脉瘤夹闭术后患者脑功能康复的影响。方法将按标准筛选出的颅内动脉瘤夹闭术后的102例患者按入院单双号半随机分为对照组和高压氧(HBO)组(各51例),对照组予以常规药物、针灸和康复治疗;HBO组除上述治疗外加用早期HBO治疗,观察两组患者治疗前、后脑血流速度、大脑中动脉痉挛情况、临床疗效、神经功能缺损评分(NFD)和Barthel评分。结果与治疗前相比,治疗后两组患者的脑血流速度均降低、大脑中动脉痉挛情况好转、NFD降低、Barthel评分升高(P<0.01),且HBO治疗组各项指标改善情况均优于对照组(P<0.01)。HBO治疗越早,效果越好。结论术后早期运用HBO综合治疗,对颅内动脉瘤患者脑血流的改善有明显效果,可显著促进其脑功能恢复。Objective To explore the curative effect of hyperbaric oxygen （HBO） on cerebral function impairment after thecraniotomy in the patients with intracranial aneurysms. Methods One hundred and two patients with intracranial aneurysms early afterthe surgery for the aneurysms were hemirandomly divided into both HBO treatment and contral groups of 51 patients each. The scores ofneurological function defect （NFD）, cerebral blood flow velocity of the middle cerebral artery （MCA） and cerebral vasospasm rate beforeand after the treatment and activities daily living （ADL） were determined and analyzed. Results The score of NFD, cerebral blood flowvelocity of MCA and cerebral vasospasm rate after the treatment were significantly lower than those before in both the groups and theywere significantly lower in HBO treatment group than those in the control group after the treatment. The score of ADL after the treatmentwas significantly higher than that before in both the groups （P0.01）, and it was significantly higher in HBO treatment group than that incontrol group after the treatment （P0.01）. Conclusion HBO therapy early after the craniotomy can significantly facilitate therehabilitation of the cerebral function in the patients with intracranial aneurysms.

关 键 词：颅内动脉瘤 脑血管痉挛 高压氧 神经功能缺损 日常生活能力 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]