高压氧治疗对高血压脑出血患者血压及再出血的影响

Influence of hyperbaric oxygen treatment on blood pressure and the rebleeding in patients with hypertensive intracranial hemorrhage

目的 探讨高压氧治疗（HBOT）对高血压脑出血（HICH）患者血压及再出血的影响.方法 120例HICH患者在病情稳定、血压控制理想后接受HBOT.分别于进舱前、治疗后出舱前、出舱后1 h测定卧位血压,同时记录治疗过程中发生再出血的例数.结果 治疗后出舱前收缩压变化情况为：升高31例（25.83%）,降低20例（16.67%）,无明显变化69例（57.50%）;舒张压变化情况为：升高69例（57.50%）,降低5例（4.17%）,无明显变化46例（38.33%）.所有患者出舱后1 h血压与治疗前比较均无显著变化.患者在治疗过程中均未发生再出血.结论 HBOT可使部分HICH患者血压短暂地波动,但在病情稳定、血压控制理想后行常规HBOT不会明显增加再出血概率.

Objective To investigate the influence of hyperbaric oxygen treatment （HBOT） on blood pressure （BP） and the incidence of rebleeding in patients with hypertensive intracranial hemorrhage （HICH）Methods One hundred and twenty patients with HICH were treated for 60 min with 100% oxygen at 2.0 absolute atmospheres （ATA） daily when the condition was stable and BP was controlled ideally. Blood pressure was measured before the patients were sent into the HBO chamber and remeasured following completion of each HBOT session and 1 hour later. Rebleeding was monitored during and after each HBO session . Results HBOT caused a significant elevation of systolic BP in 25.83% （31/120） patients and a significant decrease in 16.67% （20/120） patients （P 〈0. 05 ）,whereas the rest 57.5% （69/120） patients had no significant changes,when the BP was measured right after the HBOT session. The mean diastolic BP increased in 69 （57. 50% ） patients and decreased in 4. 17%（5/120） patients （P 〈 0. 05 ）, whereas we found no significant changes in the rest 46 （ 38.33% ） patients. No differences were found in the comparison of BP before and 1 hour after the HBOT session and no one suffered from rebleeding during and after HBOT session. Conclusions HBOT may cause temporal blood pressure changes in most patients with HICH, however, it will not cause an increasing incidence of rebleeding if the patient＇s condition is stable and the blood pressure has been well controlled.