早期高压氧治疗颅内动脉瘤破裂栓塞术后脑血管痉挛的临床研究  

Clinical study of early hyperbaric oxygen therapy on cerebral vasospasm after embolization of ruptured intracranial aneurysms

作　　者：周建宏[1] 陆爻忠[1] 蒋云召[1] 朱力平[2] 季惠君[3] 

机构地区：[1]江苏省无锡市第三人民医院神经外科,214041 [2]江苏省无锡市第三人民医院影像科,214041 [3]江苏省无锡市第三人民医院高压氧疗科,214041

出　　处：《临床合理用药杂志》2017年第13期16-18,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察高压氧治疗对破裂动脉瘤栓塞术后脑血管痉挛(CVS)的改善作用。方法将70例CVS患者随机平均分为高压氧治疗组和常规治疗组。采用Hunt-Hess分级标准评定2组治疗前后病情改变。采用经颅超声多普勒检查(TCD),记录大脑前动脉(ACA)、大脑中动脉(MCA)和大脑后动脉(PCA)的平均血流速度(V_m);CT灌注成像(CTP)检查脑血流量(CBF)、脑血容量(CBV)和造影剂平均通过时间(MTT)。结果高压氧治疗组对病情的Hunt-Hess分级改善程度高于常规治疗组(P<0.05)。高压氧治疗组的ACA、MCA、PCA、CBF、CBV和MTT显著优于常规治疗组(均P<0.05)。以格拉斯哥预后计分GOS评分统计作为疗效的评价标准,高压氧治疗组治疗后3月的预后显著高于常规治疗组(P<0.05)。结论高压氧治疗能有效缓解CVS的高峰,显著改善临床预后,对颅内动脉瘤破裂栓塞术后CVS有较好的治疗作用。Objective To observe the effect of early hyperbaric oxygen therapy on cerebral vasospasm（CVS） after embolization of ruptured intracranial aneurysms.Methods 70 cases of CVS were randomly divided into the hyperbaric oxygen treatment group and routine treatment group.Using Hunt-Hess classification criteria for the assessment of the two groups before and after treatment.Anterior cerebral artery（ACA）,middle cerebral artery（MCA） and posterior cerebral artery（PCA） of the mean flow velocity（Vm） were detected by transcranial doppler ultrasound examination（TCD）;cerebral blood flow（CBF）,cerebral blood volume（CBV） and contrast agent mean by the time（MTT） were detected by CT perfusion imaging（CTP）.ResultsHunt-Hess classification on the condition of the hyperbaric oxygen treatment group improved level was higher than that of the routine treatment group（P〈0.05）.ACA,MCA,PCA,CBF,CBV and MTT of hyperbaric oxygen treatment group were significantly higher than that of routine treatment group（P〈0.05）.By evaluating efficacy with Glasgow outcome scale（GOS）,the prognosis of the patients in the hyperbaric oxygen treatment group was significantly higher than that in the routine treatment group after three months＇ treatment（P〈0.05）.Conclusion Hyperbaric oxygen therapy can effectively relieve cerebral vasospasm peak,significantly improve clinical outcomes.It has a better therapeutic effect on cerebral vasospasm after ruptured intracranial aneurysm.

关 键 词：颅内动脉瘤 脑血管痉挛 高压氧 

分 类 号：R651.12[医药卫生—外科学]