高压氧治疗椎动脉型颈椎病血液流变学的变化  

Hemorheological changes in the patients with cervical spondylopathy of vertebral artery following hyperbaric oxygen therapy

作　　者：张允[1] 曾喻[2] 姜迎[1] 廖敏[1] 罗勇[1] 张林辉[1] 

机构地区：[1]四川省人民医院中医骨科,成都610072 [2]四川省人民医院高压氧科,成都610072

出　　处：《中华航海医学与高气压医学杂志》2016年第2期107-111,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的 探讨高压氧（HBO）对椎动脉型颈椎病（CSA）血液流变学的影响.方法 选择2011年5月至2014年10月在我院就诊的CSA患者175例,经患者知情同意,并签署知情同意书后,将入组患者按治疗方法分为3组,HBO组（60例）、针刺组（58例）和手法组（57例）,3组均予每日1次治疗,连续10d为1个疗程.使用《颈性眩晕症状与功能评估量表》在治疗前、治疗开始第10天及完成后1个月（第40天）对所有患者进行评测,在治疗前、治疗开始后第5、10天及治疗完成后1个月（第40天）,对所有患者进行血液流变学检测.组内比较采用配对t检验,治疗开始后不同时间点眩晕评分和血液流变学各指标的比较采用重复测量资料的方差分析.结果 3组治疗前后眩晕评分比较,差异有统计学意义,[治疗前：HBO组为（7.650±1.751）分、针刺组为（7.927±1.654）分、手法组为（7.872±1.749）分,治疗第10天：HBO组为（19.187±1.279）分、针刺组为（21.493±1.875）分、手法组为（23.095 ±2.312）分]（均P＜0.05）;3组治疗后不同时间点眩晕评分组间比较,差异无统计学意义（P＞0.05）,提示3种治疗方案均能有效改善患者头晕头痛症状,且效果无明显差异;3组患者治疗后血液流变学各指标与治疗前比较,差异有统计学意义（均P ＜0.05）,表明3种方法均能影响血液流变学;治疗结束后1个月（第40天）,高压氧组变化最小,高压氧组10 d血液流变学各指标与40d比较,差异有统计学意义（P＜0.05）;3组治疗后40d血液流变学各指标组间比较,差异无统计学意义（P＞0.05）,提示高压氧治疗能在较长时间内影响血液流变学.结论 将HBO用于CSA的治疗,可改善患者头晕、头痛症状,降低全血高切黏度、全血低切黏度,降低红细胞压积、血浆黏度值、纤维蛋白原等指标,从而降低血液黏稠度,影响血液流变学.Objective To explore the effects of HBO on hemorheology of the patients with cervical spondylopathy of vertebral artery （CSA）.Methods One hundred and seventy-five CSA patients who received medical care in our hospital from May 2011 to Oct 2014 were selected for the study.With the knowledge and consent of the patients and following the signing of the letter of agreement,the patients were randomly divided into 3 groups：the HBO group （n =60）,the acupuncture group （n =58） and the massage group （n =57）.The 3 groups were all given treatment once a day,with 10 days a treatment course.At day 0,10 days after the start of treatment,and 1 month after completion of treatment （or at day 40）,all the patients were evaluated by using the Cervical Vertigo Symptom and Function Assessment Scale （CVSFAS）.At the same time,hemorheologic data were detected in all the patients before treatment,at day 5 and day 10 after the start of treatment and 1 month after completion of treatment （or at day 40）.Pair T test was performed for intra-group comparison,and variance analysis of vertigo scores at different time points after the start of treatment and comparison of various hemorheologic data were performed by using repeated measurement data.Results Statistical significance could be seen in the vertigo scores before and after treatment,when comparisons were made between the 3 groups （P ＜ 0.05）.However,no statistical significance could be noticed in the vertigo scores at different time points after treatment,when comparisons were made between the 3 groups （P ＞ 0.05）,indicating that the 3 treatment schemes could all effectively improve the dizziness and headache of the patients and no obvious differences could be noted in the therapeutic.Statistical significance could also be seen in various hemorheologic data at different time points after treatment,as compared with those before treatment （P ＞ 0.05）,indicating that the 3 treatment could all affect hemorheology.One month after completion of the tre

关 键 词：高压氧 椎动脉型颈椎病 血液流变学 

分 类 号：R681.55[医药卫生—骨科学] R459.6[医药卫生—外科学]