中青年出血性脑卒中的高压氧综合治疗分析  

Analysis of hyperbaric oxygen comprehensive therapy on young and middle-age patients with hemorrhagic stroke

作　　者：范丹峰[1] 孟祥恩[1] 胡慧军[1] 李娜[1] 潘树义[1] 

机构地区：[1]海军总医院高压氧科,北京100048

出　　处：《转化医学杂志》2015年第4期218-222,共5页Translational Medicine Journal

摘　　要：目的探讨中青年出血性脑卒中的高压氧综合治疗,强调以基本医学治疗为基础,总结中青年出血性脑卒中的治疗经验。方法回顾分析海军总医院高压氧科收治的56例中青年出血性脑卒中患者资料。在行高压氧治疗前及治疗期间,重点对肺部感染、血压控制、心理状态及康复锻炼进行全面综合治疗,同时给予2个疗程以上高压氧治疗。采用格拉斯哥昏迷量表评分、Lovett肌力分级、临床表现及实验室检查结果分别判断意识、肌力及肺部感染的好转情况。结果所有患者顺利完成高压氧治疗。56例中,意识障碍好转86.2%,治疗后格拉斯哥评分显著高于治疗前(P<0.05);肢体功能好转88.9%,治疗后Lovett肌力分级较治疗前显著提高(P<0.05);肺部感染治疗总有效率100%,其中气管切开患者顺利拔除气管套管为82.5%;所有患者血压均达到控制目标;治疗过程中无并发症发生。结论高压氧配合基础疗法治疗中青年出血性脑卒中效果满意。高压氧治疗必须建立在对患者全身传统治疗的基础上,感染的控制、血压的稳定、康复的介入以及心理的疏导等都为神经损伤的恢复创造了条件、提供了机会。Objective To discuss the hyperbaric oxygen (HBO) comprehensive therapy for young and middle-age patients with hemorrhagic stroke, to emphasis on the foundation of conventional treatment, and to sum up the clinical experiences to hemorrhagic stroke in young and middle-aged pa-tients.Methods Retrospective analysis of 56 young and middle-age patients with hemorrhagic stroke admitted in department of HBO, Navy General Hospital was made.Before and during the HBO thera-py, comprehensive treatments were given on pulmonary infection, blood pressure control, psychologi-cal state adjustment, rehabilitation exercise and so on.Meanwhile, more than 2 courses of HBO thera-pies were given to the patients.Glasgow coma scale, Lovett muscle force, clinical manifestations plus laboratory, inspection results were used to assess the improvement of consciousness, muscle force and pulmonary infection respectively.Results All the patients were successfully subjected to HBO thera-pies.The improvement rate of disturbance of consciousness was 86.2%, and the GCS after treatment was significantly higher than that before treatment (P<0.05).The improvement rate of limbs dys-function 88.9%, and the Lovett muscle force was significantly improved after treatment compared with that before treatment (P<0.05).The total effective rate of pulmonay infection was 100%, and 82.5% patients receiving tracheotomy were decannulated successfully.100% of patients with hyper-tension got the goal of pressure control, and no complications occurred during the treatements.Con-clusion With the foundation of conventional treatment, HBO therapy could make the satisfactory progress in the treatment of young and middle-age patients with hemorrhagic stroke.It should be on the basis of conventional treatment.All of the infection control, blood pressure stable, rehabilitation and psychological counseling provide the opportunities and create the conditions for the recovery of nerve injury.

关 键 词：出血性脑卒中 高压氧 综合治疗 中青年 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R459.6[医药卫生—临床医学]