高压氧辅助治疗脑出血患者预后良好的临床特征分析  

Clinical characteristics analysis of hyperbaric oxygen treated intracerebral hemorrhage with good prognoses

作　　者：江桂妙 顾亚楠 张翠杰 王文飞 窦清理 Jiang Guimiao;Gu Ya’nan;Zhang Cuijie;Wang Wenfei;Dou Qingli(Emergency Department,The People’s Hospital of Baoan District,Shenzhen 518100,China)

机构地区：[1]宝安区人民医院急诊科,深圳518100

出　　处：《中华航海医学与高气压医学杂志》2025年第3期301-304,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨高压氧辅助治疗脑出血患者预后得到显著改善的临床特征。方法收集深圳市宝安区人民医院2018年1月至2021年12月收治的127例脑出血患者的临床资料,以发病第4周时改良Rankin量表(mRS)评分明显改善为标准,分为预后良好组(n=19)和预后不良组(n=108)。综合分析2组患者的临床资料,包括年龄、性别、高血压史、糖尿病史、高脂血症史、吸烟饮酒史、脑卒中史、急性冠脉综合征病史、手术治疗、出血部位、出血量、高压氧治疗疗程、发病时mRS评分、第4周mRS评分。结果单因素分析结果显示,预后良好组患者的年龄虽然偏低,但与预后不良组比较,对预后的影响差异无统计学意义(Z=-1.876,P=0.06)。预后良好组患者发病时mRS评分较高,病情较重,但对预后的影响差异无统计学意义(Z=‒1.749,P=0.08)。2组患者高血压史对预后的影响差异无统计学意义[OR=0.414,95%CI(0.154~1.110),P=0.074];2组患者在高压氧治疗疗程上差异无统计学意义(P=0.332)。多因素回归分析结果显示,手术治疗对2组的预后影响差异有统计学意义[OR=3.873,95%CI(1.084~13.834),P<0.05]。结论接受手术治疗的脑出血患者,高压氧辅助治疗预后较好,获益更多。Objective To investigate the clinical characteristics of hyperbaric oxygen treated intracerebral hemorrhage with significantly improved prognoses.Methods The clinical data of 127 patients with intracerebral hemorrhage admitted to the People’s Hospital of Baoan District of Shenzhen between January 2018 and December 2021 were collected.According to the improvement of the modified Rankin Scale(mRS)scores in the fourth week since onset,the patients were divided into a good prognosis group(n=19)and a poor prognosis group(n=108).The clinical data of these two groups were comprehensively analyzed,regarding their age,gender,history of hypertension,history of diabetes,history of hyperlipidemia,smoking and alcohol consumption history,history of stroke,history of acute coronary syndrome,surgical treatment,site of hemorrhage,volume of intracerebral hemorrhage,hyperbaric oxygen therapy duration,mRS score at onset,and mRS score at the 4th week.Results The univariate analysis showed that although the ages of the good prognosis group were lower,the age had no statistically significant impact on the prognosis compared with the poor prognosis group(Z=-1.876,P=0.06);the patients with good prognoses had higher mRS scores and more severe conditions at the onset,but made no statistically significant impact on prognosis either.(Z=-1.749,P=0.08).There was no significant difference between the two groups regarding the influence of hypertension history on prognosis[OR=0.414,95%CI(0.154~1.110),P=0.074];there was no significant difference in the course of hyperbaric oxygen treatment between the two groups(P=0.332)either.The multivariate regression analysis showed that there was a significant difference when surgical treatment was involved[OR=3.873,95%CI(1.084~13.834),P<0.05].Conclusion The patients with intracerebral hemorrhage who received surgical treatment showed better prognosis and benefited more when undergoing hyperbaric oxygen therapy as the adjunctive treatment.

关 键 词：脑出血 高压氧 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]