高压氧在心肺复苏后脑损伤治疗中的临床价值  

The Clinical Value of Hyperbaric Oxygen in the Treatment of Brain Damage afer Cardiopulmonary Resuscitation

作　　者：牛锋[1] 何岱昆[1] 李玉芳[1] 冯桂英[1] 汤红萍[1] 费强峰[1] 

机构地区：[1]复旦大学附属金山医院,上海201508

出　　处：《中国初级卫生保健》2016年第11期87-88,64,共3页Chinese Primary Health Care

基　　金：上海市金山区科学技术创新基金项目(2013-3-16)

摘　　要：目的探讨高压氧在心肺复苏后脑损伤治疗中的作用。方法回顾性分析2012年6月—2015年12月60例心肺复苏后脑损伤患者的临床资料,其中以降低颅内压、脱水及抗感染等治疗为对照组(30例),在常规治疗基础上采用高压氧治疗者为观察组(30例)。统计两组的临床疗效,于治疗前、后分别采用格拉斯哥昏迷分级(GCS)评分评价其恢复情况,并采用格拉斯哥预后分级(GOS)评价其预后情况。采用多普勒彩色超声检测两组治疗前、后脑动脉血流速度变化。结果治疗后,两组患者GCS评分、GOS评分均较治疗前明显提高,而观察组GCS评分、GOS评分升高程度较对照组更显著,差异有统计学意义(P<0.05);观察组临床总有效率93.33%,明显高于对照组的66.67%,差异有统计学意义(P<0.05)。两组治疗后大脑前动脉、中动脉血流速度较治疗前明显下降,观察组各项血流速度下降程度较对照组更显著,差异有统计学意义(P<0.05)。结论辅以高压氧治疗心肺复苏后脑损伤可有利于改善临床症状及预后。OBJECTIVE To investigate the role of hyperbaric oxygen in brain damage following cardiopulmonary resuscitation therapy. METHODS Retrospective Analysis was conducted on 60 cases of brain damage following cardiopulmonary resuscitation in patients with clinical data June 2012 - December 2015, which reduced intracranial pressure, dehydration and anti-infection treatment for the control group （30 cases）, high pressure in the conventional treatment based on oxygen treatment in the observation group（30 cas- es）. Statistics clinical efficacy, before and after treatment were used Glasgow Coma Scale （GCS） score evaluation of its recovery, and the use of Glasgow Outcome Classification （GOS） to evaluate the prognosis. Using color Doppler ultrasound before and after treat- ment, changes in cerebral artery blood flow velocity. RESULTS After treatment, patients were GCS score before GOS scores were sig- nificantly improved treatment and then observation group GCS score, GOS score increased more significant degree than the control group, P〈0.05; clinical observation group total effective rate 93.33%, significantly higher in the control group, 66.67%, P〈0.05. Af- ter treatment, the anterior cerebral artery, anterior artery blood flow velocity decreased significantly compared with before treatment, the blood flow velocity in the observation group decreased more significant degree than the control group, P〈0.05. CONCLUSION Hy- perbaric oxygen therapy combined with brain damage following cardiopulmonary resuscitation may help to improve the clinical symp- toms and prognosis.

关 键 词：高压氧 心肺复苏 脑损伤 预后 血流速度 

分 类 号：R458[医药卫生—治疗学]