高压氧对颅脑损伤患者认知功能的影响  

Clinical study on the influence exerted by hyperbaric oxygen therapy on cognitive impairments after a craniocerebral injury

作　　者：张文超[1] 孙昭胜[1] 相毅[1] 杨雪辉[1] 李晓卫[1] 李永谦[1] 陈建超[1] 毛建辉[1] 赵旺淼[1] 张明哲[1] 张万增[1] 

机构地区：[1]衡水哈励逊国际和平医院,河北衡水053000

出　　处：《山东医药》2013年第4期17-19,23,共4页Shandong Medical Journal

基　　金：河北省科技支撑计划项目(102761119)

摘　　要：目的探讨高压氧干预治疗下,不同治疗时间段颅脑损伤患者认知功能变化,对其疗效进行评定。方法重型颅脑损伤并发认知障碍患者60例,随机分为高压氧组(30例)和常规治疗组(30例),高压氧组在常规治疗基础上,正规高压氧治疗0、12、24、40、60 d时,由独立的心理医师,对比改良长谷川痴呆量表(HDS)和临床痴呆量表(CDR)评分变化。结果高压氧组有效率96.7%,治愈率66.7%;对照组有效率90%,治愈率40%。治疗第12天起,高压氧组HDS评分高于对照组评分,治疗第24、40天差异最显著;治疗第12天起,高压氧组CDR评分均低于对照组评分,治疗第12～40天差异明显。HDS评分中定向力、记忆力、计算力及近期记忆经过SPSS检验比较均有显著统计学差异(P<0.01),而日常知识项比较差异不显著(P>0.05)。结论高压氧对颅脑损伤患者的定向力、记忆力、计算力及近期记忆均有康复作用,其中近期记忆改善最为明显,对长期记忆(日常知识)效果不明显。Objective To explore the cognitive level and the degree of coma after a craniocerebral injury and how the cognitive function will change in different periods during the hyperbaric intervention treatment,＇ and assessing the outcomes of this therapy. Methods Sixty patients who had a heavy craniocerebral injury with cognitive impairment were randomly divioled into hyperbaric oxygen group and control group. By independent psychiatrists, the results had been contrasted the change through improved hasegawa dementia scale （HDS） and clinical dementia scale （CDR） after 0,12,24,40 and 60 d. Results The effective rate of hyperbaric oxygen group was 96.7%, with the cure rate 66.7%. The effective rate of the control group was 90% , while the cure rate was 40%. HDS score of the hyperbaric oxygen group was found to be higher than that of the control group in the 12th days, and the difference became obvious between the 24th days and 40th days. CDR score of the hyperbaric oxygen group was found to be lower than that of the control group in the 12th days, and the difference became obvious between the 24th to 40th days. Before and after treatment, the orientation, memory, computing power, knowledge and recent memory were compared between hyperbaric oxygen group and control group. HDS rating in the orientation, memory, computing power and recent memory showed significant difference （P 〈 0.01 ） through SPSS sta- tistical test, while the daily knowledge item indicated no significant difference （ P 〉 0.05）. Conclusions Hyperbaric oxy- gen is good for the orientation, memory, computing power of patients with traumatic brain injury. The influence of hyper- baric oxygen on improvement of recent memory is obvious, but with the opposite effect on improvement of long-term memory （ daily knowledge）.

关 键 词：颅脑损伤 高压氧 认知障碍 改良长谷川痴呆量表 临床痴呆量表 

分 类 号：R493[医药卫生—康复医学]