高压氧治疗全程脑血流图的动态观察分析  

Dynamic state of rheoencephalography during procedure of hyperbaric oxygen therapy

作　　者：王宏隽[1] 翁其彪[1] 陈玲珍[1] 陈雪林[1] 张晓菁[1] 王晓雯[1] 尹娜[1] 

机构地区：[1]南方医科大学珠江医院高压氧科,广州510282

出　　处：《中华神经医学杂志》2013年第8期823-826,共4页Chinese Journal of Neuromedicine

摘　　要：目的 探讨高压氧治疗不同阶段脑血管功能及脑血流的变化及规律,为脑部疾病的高压氧治疗提供临床依据. 方法 选择珠江医院高压氧科自2010年11月至2011年5月行高压氧治疗的49例脑部疾病患者,应用脑血流图自动分析仪,在治疗开始升压前（Ⅰ阶段）、稳压后未吸氧前（Ⅱ阶段）、吸氧40 min后（Ⅲ阶段）、减压结束压力降至常压时（Ⅳ阶段）4个阶段对颈内动脉和椎动脉系统进行脑血流图描记,并对描记结果进行对照分析. 结果 颈内动脉和椎基底动脉系统的变化规律基本一致.反映脑血流量的指标如波幅、波幅差、总充盈面积和速率在高压氧治疗过程4个阶段间总体比较差异无统计学意义（P＞0.05）；反映血管紧张度与弹性的指标如弹性指数、上升角、顶夹角、充盈时间、幅值在高压氧治疗过程4个阶段间总体比较差异有统计学意义（P＜0.05）；反映脑血管阻力的指标如阻力指数、上升时间、转折高比值在高压氧治疗过程4个阶段间总体比较差异有统计学意义（P＜0.05）. 结论 高压氧治疗对于脑血流量影响不大,主要是血管阻力和紧张度方面的改变.Objective To observe the brain cerebrovascular function and blood flow changes in patients with brain diseases during hyperbaric oxygen therapy of different states to provide evidence for their clinical treatment.Methods Forty-nine patients with brain diseases,admitted to our hospital from November 2010 to May 2011,were chosen in our study; their rheoencephalography data captured during a complete hyperbaric oxygen therapy of 4 different states were collected and compared; these 4 states were：state Ⅰ,before pressure raising,which could also be the beginning of the therapy; state Ⅱ,before oxygen intake while pressure coming to a stable level; state Ⅲ,40 min after oxygen uptake; and state Ⅳ,while the pressure inside the chamber coming back to normal level.Results Carotid artery and vertebrobasilar system enjoyed likely changes.Parameters of rheoencephalography showing cerebral blood flow changes,including impedance,raising time,total retraction time and high turn ratio,did not show any differences among the four states （P〉0.05）,those showing vascular tension and elasticity,including elasticity index,angle of increasing,top angle of peak value,filling time and amplitude,showed statistically significant difference between each 2 states （P〈0.05）,and those showing cerebral vascular resistance,such as resistance index,rising time and high turn ratio,showed significant difference between each 2 states （P〈0.05）.Conclusion The hyperbaric oxygen therapy has little effect on changing the brain blood flow; it mainly functions as controlling the impedance and extending the contraction of brain vascular.

关 键 词：高压氧 脑血流图 血管阻力 血管紧张度 

分 类 号：R459.6[医药卫生—治疗学]