268例高血压脑出血高压氧治疗临床资料分析  

Clinical data analysis on 268 cases of hypertensive cerebral hemorrhage treated with hyperbaric oxygen

作　　者：田洪[1] 周虎传[1] 张玉波[1] 宋川[1] 郝磊[1] 刘磊[1] 

机构地区：[1]解放军324医院脑血管病中心,重庆400020

出　　处：《西南国防医药》2015年第9期932-935,共4页Medical Journal of National Defending Forces in Southwest China

基　　金：重庆市自然科学基金项目(cstc2012jj A10155)

摘　　要：目的探讨高压氧治疗对高血压脑出血患者的疗效及高压氧治疗时程对疗效的影响。方法将268例脑出血患者随机分成对照组(未进行高压氧治疗)及高压氧治疗4 w、8 w、12 w组。应用NIHSS、MMSE及HAMD量表和BAEP、SEP、P300于治疗前及治疗后3个月,对患者进行神经功能、认知功能及抑郁量化评定;行头颅CT检查,根据多田公式计算治疗前及治疗后1 w脑水肿体积;统计治疗期间癫痫与再出血的发生率。结果与对照组比较,治疗后,高压氧治疗组神经功能缺损伤程度较轻,认知功能恢复较好,抑郁程度轻,有明显的疗效。高压氧治疗12 w组的神经与认知功能恢复的程度明显优于高压氧治疗4 w组的患者(P<0.05或P<0.01)。结论脑出血后高压氧治疗可以减轻脑水肿,改善患者的神经功能,减少抑郁并发症的程度及发生率,且在脑出血神经功能康复期内,高压氧治疗时程越长,疗效越明显,且不会增加癫痫发作或再次脑出血风险。Objective To discuss the effects of hyperbaric oxygen treatment on the time course and curative effects on patients with hypertensive cerebral hemorrhage. Methods 268 patients with cerebral hemorrhage were randomly divided into control group （not receiving the hyperbaric treatment） and therapeutic group （treated with hyperbaric oxygen for four, eight, and twelve weeks respectively）. Neurological function, recognition, and depression were evaluated for patients three months before and after the treatment using NIHSS, MMSE, and HAMD scales and BAEP, SEP, and P300 scoring system. The patients received the CT examination on head, and cerebral edema volume was measured by DoTians formula before and one week after the treatment. Incidence of epilepsy and re-hemorrhage during the treatment was calculated. Results Compared with the situation of the control group, in the hyperbaric oxygen treatment group, the neurologic impairment was less, and depression degree was milder. The recognition function recovered better. And the curative effects were significant. The neurological and recognition function recovery in the group receiving hyperbaric oxygen treatment for 12 weeks was obviously superior to that in the group receiving the treatment for 4 weeks（P〈 0.05 or P〈 0.01）. Conclusion Hyperbaric oxygen treatment after cerebral hemorrhage can mitigate cerebral edema, improve the neurological function, and decrease the degree and incidence of depression complications. During the neurological function rehabilitation period, the longer the time course of hyperbaric oxygen treatment is, the more significant the curative effect is, which will not increase the risk of epilepsy and cerebral re-hemorrhage.

关 键 词：高压氧 脑出血 时程 疗效 

分 类 号：R743.2[医药卫生—神经病学与精神病学]