不同时机介入高压氧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(HBO)治疗对急性脑梗死疗效的影响。方法根据发病至高压氧介入的不同时机将患者随机分为4组:HBO超早期治疗组(发病~6 h)、HBO早期治疗组(发病6 h^7 d)、HBO晚期治疗组(发病8~14 d)和对照组,对照组予脑梗死常规药物+康复治疗,HBO治疗组在此基础上予HBO治疗,观察治疗后2个月的疗效。结果 4组患者治疗后神经功能缺损(NFD)评分均较自身治疗前明显下降,且差异有统计学意义(P<0.05)。治疗后4组间NFD评分比较,HBO超早期治疗组(10.10±8.473)<HBO早期治疗组(14.66±7.650)<HBO晚期治疗组(18.92±6.471)<对照组(22.28±5.927),差异均有统计学意义(P<0.05)。HBO超早期治疗组、HBO早期治疗组、HBO晚期治疗组、对照组总有效率分别为97.50%、84.80%、74.21%、64.21%,组间两两比较差异均有统计学意义(P<0.05),HBO超早期组、早期治疗组疗效明显优于对照组。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 According to the different therapy of hyperbaric oxygen, patients were randomly divided into 4 groups：super early hyperbaric oxygen treatment group（0-6 h）, early hyperbaric oxygen treatment group（6 h-7 d）, late hyperbaric oxygen treatment group（8-14 d） and control group.The control group was given traditional drugs and rehabilitation treatment of acute ischemic stroke.The super early hyperbaric oxygen treatment group, early hyperbaric oxygen treatment group and the late hyperbaric oxygen treatment group were given hyperbaric oxygen therapy. The therapeutic effect of each group was observed after treatment for 2 months. Statistical software SPSS19.0 was used for data analysis. Results After treatment, the scores of the neurological functional defects（NFD） in four groups were improved（P〈0.05）, and the scores of NFD in the super early hyperbaric oxygen treatment group（10.10 ±8.473）were the lowest,the scores of NFD in the early hyperbaric oxygen treatment group（14.66±7.650） and the late hyperbaric oxygen treatment group were lower（18.92±6.471） than that in the control group（22.28±5.927）; there were significant differences among the 4 groups. The effective rates of super early hyperbaric oxygen treatment group（0-6 h）, early hyperbaric oxygen treatment group（6 h-7 d）, late hyperbaric oxygen treatment group（8-14 d） and control group were 97.50%, 84.80%, 74.21%, 64.21%, respectively, showing no significant differences among the 4 groups（P〈0.05）. The clinical effects of super early hyperbaric oxygen treatment group and early hyperbaric oxygen treatment group were better than the other groups, showing significant differences among the four group.Conclusion Hyperbaric oxygen treatment can significantly improve the restoration of disability in patients with acute cerebral infarction, and it was better for earlier treatment.