高压氧对体外循环心脏术后精神障碍的辅助治疗作用

Adjunctive Hyperbaric Oxygen Therapy for Mental Disorders after Cardiac Surgery with Cardiopulmonary Bypass

目的观察高压氧(Hyperbaric Oxygen,HBO)对体外循环(Cardiopulmonary Bypass,CPB)心脏术后精神障碍的治疗作用。方法对观察组17例CPB心脏术后精神障碍患者进行HBO辅助治疗,再对相关临床资料进行匹配,将另外17例术后精神障碍患者列入对照组,比较治疗前后两组患者在简易精神状态测验(MMSE)评分、汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分和精神障碍治疗疗程上的差别。结果 (1)两组患者围手术期在年龄、性别、受教育年限、手术类型、合并高血压、糖尿病例数、CPB时间、ICU停留时间、术后精神障碍类型等方面比较均无统计学差异(P>0.05)。(2)经治疗后两组患者的MMSE评分较治疗前明显提高,且所有患者评分基本恢复至正常水平,而HAMD和HAMA评分较治疗前明显下降(P<0.05),但经治疗后两组患者之间的评分无统计学差异(P>0.05);观察组患者进行精神障碍治疗的疗程较对照组明显缩短(P<0.05)。结论在CPB术后出现精神障碍的患者除了进行常规药物治疗外,HBO辅助治疗能较有效地促进患者恢复。

Objective To observe the therapeutic effects of hyperbaric oxygen（HBO） on mental disorders after cardiac surgery with cardiopulmonary bypass （CPB）. Methods 17 cases of mental disorders after CPB cardiac surgery were enrolled in observation group and underwent adjunctive HBO therapy while another 17 cases of the same disease were enrolled in control group;a comparative study was made to the scores of mini-mental state examination （MMSE）, Hamilton depression scale （HAMD） and Hamilton anxiety scale （HAMA） of the cases before and after treatment between the 2 groups. Results 1. There existed no statistical difference in age, gender, education years, operation types, case number of complication with hypertension and diabetes, CPB time, duration in ICU and types of postoperative mental disorders between the 2 groups （P〉0.05）;2. The scores of MMSE after treatment in both groups were much higher than those before treatment and all reached the normal while the scores of HAMD and HAMA were much lower than those before treat-ment （P〈0.05）;the scores after treatment in the 2 groups were of no statistical significance （P〉0.05）;the course for cases in observation group was shorter than that in control group （P〈0.05）. Conclusions Adjunctive HBO therapy on the basis of routine drug treatment can effectively improve the recovery of patients with mental disorders after CPB surgery.