微创钻颅与高压氧治疗脑出血后脑循环动力学的变化

Changes of haemodynamics parameters of patients with cerebral hemorrhage after micro-found drilling cranium and hyperbaric oxygen therapy

目的探讨微创钻颅术（微创术）与高压氧（hyperbaric oxygen，HBO）治疗脑出血的效果。方法将455例脑出血患者分成微创术加高压氧治疗组（HBO组）297例，单用微创术组（对照组）158例。分别观察各组的临床疗效、日常生活能力（activity of daily living，ADL）及治疗前后脑血管功能检测（cerebral vascular function determination，CVD）的变化。结果HBO组的有效率和显效率均明显优于对照组（P〈0．05）；ADL恢复明显高于对照组（P〈0．05）；HBO组治疗后CVD有显著改善（P〈0.01），明显优于对照组（P〈0．05）。结论脑出血早期微创钻颅引流后的HBO治疗，可以明显提高治愈率，减少致残率，提高患者的生存质量和生活质量。CVD对指导治疗、预测疗效具有积极的作用。

Objective To study the effect of micro-found drilling cranium and hyperbaric oxygen （HBO） on cerebral hemorrhage. Methods A total of 455 cases of cerebral hemorrhage were divided into two groups. HBO group （297 cases） were treated with HBO after micro-found drilling cranium and the control group （158 cases） were single with micro-found drilling cranium. Therapeutic effects, activity of daily living and the changes of cerebral vascular function determination before and after treatment were observed in each group. Results The effective rate, excellence rate, the independently completing daily live rate and cerebral vascular function in HBO group were significantly higher than those in control group （ P 〈 0. 05 ）. There lied obviously differences in cerebral vascular function determination between before and after HBO therapy （P 〈 0.01 ）. Conclusions The treatment of HBO after micro-found drilling cranium on cerebral hemorrhage can significantly increase the cure rate, decrease mutilation rate, and enhance the patients＇ survival and living quality. Cerebral vascular function determination may give some clues to prognosis and therapy.