高压氧综合治疗放射性脑水肿的疗效观察

Observation on the Efficacy of Hyperbaric Oxygen Combination Therapy for Radiation-induced Cerebral Edema

【目的】探讨高压氧综合药物治疗放射性脑水肿以及脑水肿所致神经功能缺损的治疗效果。【方法】选取2008～2011年住院的放射性脑水肿患者42例，18例为治疗组，24例为对照组，两组都给予甘露醇、地塞米松、速尿等药物治疗。观察组加用高压氧，0．22MPa，每日一次，4个疗程。分别在2个疗程、4个疗程结束时复查头颅MRI，并测量脑水肿体积进行比较，并且评估两组神经功能缺损强度（NFD）。【结果】在2个疗程后，两组脑水肿体积均有下降，组间比较差异有显著性（P〈0．05）；4疗程后对照组脑水肿体积虽有减少，但差异无显著性，而观察组脑水肿体积进一步减少，与对照组相比差异有显著性（P〈0．01）。两组神经功能缺损强度评分的差异有统计学意义（P〈0．05）。【结论】高压氧治疗能减轻放射性脑水肿的程度和范围，有利于神经功能恢复。早期、足疗程的高压氧治疗可使患者受益。

[Objective] To explore the efficacy of hyperbaric oxygen（HBO） combined with drugs for the treat- ment of radiation-induced cerebral edema and neurologic function impairment. [Methods]Totally 42 patients with radi- ation-induced cerebral edema in hospital from 2008 to 2011 were divided into observation group（n= 18） and control group（ n =24）. Both groups were given mannitol, dexamethasone and fursemide. The observation group was addi- tionally treated with HBO 0.22MPa once a day for 4 courses. At the end of 4 courses, cranial MRI was reexamined, and edema volume was measured and compared. Neurological impairment density（NFD） of two groups were evalua- ted. [Results] After 2 courses of treatment, edema volume of both groups decreased, and there was significant differ- ence between 2 groups（ P d0.05）. After 4 courses of treatment, edema volume of control group decreased and had no significant difference, while that of observation group further decreased, and there was significant difference be- tween 2 groups（ P 〈0.01）. There was significant difference in the scores of NFD between 2 groups（ P d0. 05）. [Conclusion]HBO can decrease the range and severity of radiation-induced cerebral edema, and is helpful for the re- covery of nerve function. Early and enough HBO treatment are beneficial for patients.