原发性脑干卒中患者意识状态量化评估及高压氧治疗效果回归分析  

Quantitative evaluation of the consciousness state in brainstem stroke patients and regression analysis of the therapeutic effect of hyperbaric oxygen

作　　者：高志强 潘兴明 高继荣 刘亚峰 汪长豹 Gao Zhiqiang;Pan Xingming;Gao Jirong;Liu Yafeng;Wang Changbao(Nanjing Zijin Hospital,Nanjing 211100,China)

机构地区：[1]南京紫金医院,南京211100

出　　处：《中华航海医学与高气压医学杂志》2022年第4期465-468,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的:探讨原发性脑干卒中患者意识状态的量化评估及高压氧(HBO)治疗与转归的相关性。方法:收集2020年1月至2021年6月入住南京紫金医院接受HBO综合治疗的原发性脑干卒中且排除脑干外中枢神经损伤和代谢及药物影响的患者54例。将卒中容积量分为<6 ml、6~10 ml、>10 ml 3组,卒中定位分为中脑、桥脑、中脑合并桥脑、延脑4组;测定每位患者的中国南京持续植物状态评分量表(CNPVSS)分值。对比不同卒中容积量和不同定位分组患者出院前和入院时的意识状态,并探讨疾病转归的影响因素及相关性。结果:本组患者CNPVSS评分入院时为7(1,17)分,出院前为13(3,19)分,差异有统计学意义(P<0.01);不同脑干卒中容积量患者入院时、出院前的意识状态构成差异均有统计学意义(P<0.01),而不同卒中定位患者组间差异无统计学意义(P>0.05);CNPVSS评分与HBO治疗次数呈正相关(P=0.040),与卒中容积量呈负相关(P<0.05)。结论:CNPVSS可用于量化评估脑干卒中患者的意识状态;脑干卒中容积量对患者意识水平的影响大于卒中定位的影响;HBO治疗可能是促进脑干卒中患者意识好转的积极因素。Objective To discuss the quantitative evaluation of the consciousness state in patients with primary brainstem stroke(PBS)and the correlation between the hyperbaric oxygen(HBO)therapy and the outcomes of PBS patients.Methods A total of 54 PBS patients admitted to Nanjing Zijin Hospital for comprehensive HBO treatment from January 2020 to June 2021 were selected,according to the exclusion criteria that the patient should not have central nerve injuries outside the brainstem,metabolism disorders,or on medication that may affect their consciousness states.According to stroke volume,the 54 subjects were divided into three groups:<6 ml,6-10 ml,and>10 ml.According to stroke location,they were divided into four groups:midbrain,pons,midbrain-to-pons,and medulla oblongata.The Chinese Nanjing Persistent Vegetative State Scale(CNPVSS)score of each patient was measured.The consciousness states of the patients before discharge and at admission were compared between groups of different stroke volumes and stroke locations,and the influencing factors of outcome and their correlations with outcomes were explored.Results The CNPVSS scores of all patients was 7(1,17)at admission and 13(3,19)before discharge,and the difference was statistically significant(P<0.01).Consciousness states differed significantly among groups with different brainstem stroke volumes,both at admission and before discharge(P<0.01),but there was no significant difference in consciousness states among groups with different stroke locations(P>0.05).The CNPVSS score was positively correlated with the times of HBO therapy(P=0.040),and negatively correlated with the stroke volume(P<0.05).Conclusion The CNPVSS can be used to quantitatively evaluate the consciousness state of the patients with brainstem stroke.The effect of brainstem stroke volume on the consciousness states was greater than that of stroke location.HBO therapy may be a positive factor in improving the consciousness states in patients with brainstem stroke.

关 键 词：脑干卒中 意识 中国南京持续植物状态量表 高压氧治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]