高压氧治疗时机对急性脑梗死疗效影响的临床研究

Clinical study of the effect of hyperbaric oxygen therapy started at different time on patients with acute cerebral infarction

目的探讨不同时机介入高压氧治疗对急性脑梗死疗效的影响。方法将300例急性脑梗死患者随机分为对照组、高压氧早期(发病～7 d内)治疗组及高压氧晚期(发病8～14 d)治疗组各100例,对照组予常规药物+康复治疗,高压氧治疗组在此基础上予高压氧治疗,1次/d,10次为1疗程,共治疗3疗程,每组均观察2个月,于治疗前及治疗后2个月采用改良的爱丁堡-斯堪的那维亚脑卒中量表进行神经功能缺损评分(NFD),比较三组患者治疗前后NFD。结果治疗2个月后三组患者神经功能缺损均较治疗前改善(P均<0.01);三组患者NFD比较,高压氧早期治疗组<高压氧晚期治疗组<对照组(P<0.05或P<0.01)。高压氧早期治疗组的临床疗效优于对照组(P<0.01)。结论高压氧治疗可明显促进急性脑梗死患者的神经功能恢复,且治疗时机越早疗效越好。

Objective To study the influence of different starting time of hyperbaric oxygen therapy on acute cerebral infarction. Methods 300 patients with acute cerebral infarction were randomly divided into 3 groups with 100 cases each ： control group, early hyperbaric oxygen treatment group （0 ～ 7 d） and late hyperbaric oxygen treatment group （8 ～ 14 d）. The control group was given traditional drugs and rehabilitation treatment of acute ischemic stroke. The early hyperbaric oxygen treatment group and the late hyperbaric oxygen treatment group were given hyperbaric oxygen therapy once a day for 30 days based on the routine treatment. Modified Edinbergh - Scandinavia stroke scale was employed to evaluate the neurological functional defects （NFD） before and after treatment for 2 months in the 3 groups . Result After treatment, the scores of NFD in three groups were improved （ P 〈 0.01 ）, and the scores of NFD in the early hyperbaric oxygen treatment group were lowest , the scores of NFD in the late hyperbaric oxygen treatment group were lower than that in the control group, there were significant differences between the 3 groups （ P 〈 0.05 or P 〈 0.01 ）. The clinical effects of early hyperbaric oxygen treatment group was better than control group （P 〈 0.01 ）. Conclusion Hyperbaric oxygen treatment can significantly improve the restoration of disability in patients with acute cerebral infartion, and it was more effective in the earlier treatment.