脑出血患者微创术后早期高压氧治疗对脑水肿及神经功能影响的研究

Study on the effect of early hyperbaric oxygen therapy on cerebral edema and neural function in patients with cerebral hemorrhage after microinvasive surgery

目的探讨脑出血患者微创术后早期高压氧治疗对脑水肿及神经功能的影响。方法脑出血行微创血肿清除术的患者80例,采用高压氧治疗者44例为观察组,不采用高压氧治疗者36例为对照组,观察组患者在术后24 h后无活动性出血时给予高压氧治疗30 d,观察患者治疗前及治疗后不同时段神经功能缺损(NIHSS)及脑水肿面积变化。结果观察组治疗后2周、4周时脑水肿面积明显小于对照组(P<0.05),两组治疗后2周、4周时脑水肿面积均较治疗前明显减小(P<0.05);观察组治疗后2周、4周、8周、12周时神经功能缺损评分均较治疗前明显降低(P<0.05),对照组治疗后4周、8周、12周时神经功能缺损评分均较治疗前明显降低(P<0.05);观察组治疗后4周、8周、12周时神经功能缺损评分明显低于对照组(P<0.05)。结论脑出血患者微创术后早期给予高压氧治疗能明显改善患者脑水肿,促进神经功能的恢复。

Objective To explore the effect of early hyperbaric oxygen therapy on cerebral edema and neural function in patients with cerebral hemorrhage after invasive surgery. Methods 80 of patients with cerebral hemorrhage after microinvasive surgery,44 cases of observation group received hyperbaric oxygen therapy for 30 d 24h after surgery if no active bleeding occurred,36 cases that were reluctant to adopt hyperbaric oxygen treatment were as control group. Nerve function defect（ NIHSS） scores and the change of cerebral edema area before and different periods after treatment were observed. Results Two weeks and 4weeks after treatment,cerebral edema area decreased obviously in both groups,but the changes was more significant in the observation group. NIHSS decreased significantly 2 weeks,4 weeks,8 weeks and 12 weeks after treatment in the observation group,and 4 weeks,8 weeks and 12 weeks in the control group,and it was obviously lower in the observation group than in the control at 4 weeks,8 weeks,12 weeks after treatment（ all P〈0. 05）. Conclusion Early hyperbaric oxygen therapy on cerebral edema and neural function in patients with cerebral hemorrhage after microinvasive surgery can apparently improve brain edema,and promote neural functional recovery.