200例脑出血术后早期高压氧治疗的疗效分析

The analysis of the therapeutic effect of 200 cases of early hyperbaric oxygen treatment after the operation of cerebral hemorrhage

目的分析200例脑出血术后高压氧治疗的机制及临床疗效。方法 200例脑出血患者,其中98例自发性脑出血,102例外伤性脑出血。按治疗时间分为早期治疗组≤10d80例和晚期治疗组≥20d120例。两组患者高压氧治疗措施相同,治疗结果进行统计学分析。结果术后12个月按照COS预后计分评定,两组患者生活质量均较未行高压氧治疗的患者有明显提高。Cos4分以上早期治疗良好率为67.5%。而≥20以上的治疗良好率为37.5%,P<0.01差异显著,有统计学意义。结论脑出血术后患者及早进行高压氧治疗可减轻术后脑水肿,降低颅内压。同时还可提高细胞的氧含量及氧储存量改善微循环,减少脑细胞的变形坏死。高压氧还可增加血肿周围及手术入路周围的受损细胞的供氧,加速受损细胞的恢复。高压氧还可加速残留脑水肿的清除,加速胶原纤维和毛细血管的再生,加速病灶的修复。因此早期高压氧治疗可以提高生活质量,减少致残率。

Objective To analyze the mechanism and clinical effects of hyperbaric oxygen treatment ＇after the operation of cerebral hemorrhage. Methods Among 200 cases of cerebral hemorrhage,98 cases are spontaneous cerebral hemorrhage whereas 102 cases are traumatic cerebral hemorrhage. According to the treatment time, they are divided into early treatment group, which consists of 80 people and takes no more than ten days, and late treatment group,which consists of 120 cases and takes no less than 20 days. The two groups of patients take the same measure of hyperbaric oxygen treatment and the treatment outcome is statistically analyzed. Restults Twelve months after the operation, the life quality of the two groups of patients is markedly improved than that of the patients who don＇t receive hyperbaric oxygen treatment according to the outcome scale of cos. As for the patients who have higher score than 4 ,the recovery rate is 67.5%. However,concerning the patients who have higher score than 20, the recovery rate is 37.5 %. The probability is lees than 1 percent and the marked difference is statistically significant. Conclusion The patients after the operation of cerebral hemorrhage receive the hyperbaric oxygen treatment can ease postsurgical brain edema and lower intracranial pressure. At the same time,it can increase the content and storage of the oxygen in the cell so as to improve the microcirculation as well as the deformation and necrosis of the brain cell. Hyperbaric oxygen can increase the supply of oxygen of the damaged cells around the hematoma and operative routes, and speed up the restoration of the damaged ceils. Hyperbaric oxygen can accelerate the removal of residual brain edema and the regeneration of collagen fiber and capillary vessel as well as the restoration of focus of infection. Therefore, early hyperbaric oxygen treatment can raise life standard and reduce incidence of disability.