颅内动脉瘤术后早期高压氧治疗对患者恢复的影响  

Influences of early hyperbaric oxygenation on postoperative recovery of intracranial aneurysmspatients

作　　者：唐晓平[1] 张涛[1] 彭华[1] 谭敏[1] 漆建[1] 唐文国[1] 段军伟[1] 罗仁国[1] 梅才君[1] 陈灵[1] 

机构地区：[1]川北医学院附属医院神经外科,四川南充637000

出　　处：《中华神经外科杂志》2011年第5期574-578,共5页Chinese Journal of Neurosurgery

基　　金：四川省医学重点建设学科基金资助（川卫办发[2007]407号）;四川省卫生厅科研项目资助（050059,070301）

摘　　要：目的探讨高压氧（HBO）对颅内动脉瘤术后患者的治疗作用。方法将120例前循环动脉瘤术后患者分为HBO治疗组和对照组，各60例。HBO治疗组在对照组治疗的基础上，早期应用HBO治疗，分别于术后1、3、7、14、21d测定两组患者手术入路侧大脑中动脉平均血流速度；于术后1、7、14、21d复查头颅CT，计算入路侧及术区异常密度体积；于术后3、7、14d统计两组患者伴有“症状性脑血管痉挛”例数；术后3、21d统计两组患者的机能状态（KPS评分），并做统计学分析。结果两组术后3d内大脑中动脉平均血流速度、伴有“症状性脑血管痉挛”例数、KPS评分均无统计学意义（P〉0．05）；术后7、14dHBO治疗组血流速度较对照组低（P〈0．05或P〈0．01）；术后14、21d，HBO治疗组患者异常密度体积较对照组小（P〈0．05）；术后7、14dHBO治疗组表现有“症状性脑血管痉挛”较对照组少（X^2=4．18，P〈0．05）；术后21dHBO治疗组KPS评分高于对照组（P〈0．05）。结论颅内动脉瘤术后早期应用HBO治疗效果较好，其作用机制之一可能是HBO能够尽快地解除脑血管痉挛状态。Objective To explore the effects of early hyperbaric oxygenation （ HBO ） on postoperative recovery of intracranial anenrysms patients. Methods The clinical data of 120 postoperative intracranial aneurysms patients were divided into HBO group and control group. The determination of average blood stream speed of middle cerebral artery（MCA） of operation side were recorded at the l st,3th,7th, 14th and 21 st day after operation. The operative regional abnormity density volume of CT re-examination were calculated at the 1st, 7th, 14tb and 21st day. The number of cases associated with ＂ symptomatic cerebral vasospasm＂ was counted at the 3st, 7th and 14st day. The functional state （KPS score） was evaluated at the 3th and 21 st day. Result There was no significant difference of MCA average blood stream speed, number of cases associated with ＂symptomatic cerebral vasospasm＂ and KPS score between two groups at 3rd day after operation（ P 〉 O. 05 ）. The MCA average blood stream speed of HBO group was lower than that of control group at the 7th and 14th day after operation （ P 〈 0.05 and P 〈 0. 01 ）. The abnormity density volume of HBO group was less than that of control group at the 14th and 21st day after operation （ P 〈 0. 05 ）. The number of cases associated with ＂symptomatic cerebral vasospasm＂ of HBO group was smaller than that of control group at the 7th and 14th day after operation （ P 〈 0. 05）. The KPS score of HBO group was higher than that of control group at the 21 st day after operation （ P 〈 0. 05 ）. Conclusion The effects of early hyperbaric oxygenation therapy on postoperative intraeranial aneurysms patients are good. One of the possible mechanism is release of cerebral vasospasm.

关 键 词：颅内动脉瘤 脑血管痉挛 高压氧治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]