高血压脑出血病人血肿清除术后高压氧治疗的疗效分析

Effects of hyperbaric oxygen therapy on the patients with hypertensive cerebral hemorrhage after evacuation of hematoma

目的观察高血压脑出血病人血肿清除术后高压氧治疗的疗效。方法收集我院在发病后24 h内行血肿清除术的高血压脑出血病人89例,分为对照组43例,治疗组46例。术前评估Glasgow昏迷评分(GCS)、神经功能缺损评分(NIHSS),并测量血压。术后2组常规吸氧2~5 L/min,第4天开始治疗组行高压氧(HBO)治疗,1次/d,共20 d。术后1周、1月记录病人存活情况、GCS、NIHSS、Glasgow预后评分(GOS)结果。结果术后1周时,治疗组GCS评分较对照组明显升高(P=0.022),NIHSS评分明显降低(P=0.037)。术后1月时,治疗组病人的GCS(P=0.010)、GOS评分(P<0.001)明显高于对照组,而NIHSS评分显著低于对照组(P<0.001)。结论高压氧治疗可改善高血压脑出血病人血肿清除术后的治疗效果。

Objective To observe the effects of hyperbaric oxygen （HBO） treatment on the patients with hypertensive intracerebral hemorrhage （HICH） after evacuation surgery of hematoma. Methods Eighty-nine patients with HICH receiving operation in 24 h after disease attack were enrolled in this study, and were divided into the control group （ n = 43） and HBO group （ n = 46）. The Glasgow coma score （GCS）, national institute of health stroke scale （NIHSS） score and blood pressure of the patients were evaluated before surgery. After operation, two groups received inhalation of oxygen of 2- 5 L/rain, and HBO treatment was given to HBO group once per day for 20 days since the fourth day after surgery. The survival situation, GCS, NIHSS and Glasgow outcome score （GOS） were recorded 1 week and 1 month after surgery. Results 1 week after operation, GCS of HBO group was significantly higher than that of control group （P = 0. 022）, while NIHSS was significantly lower （P = 0. 037）. 1 month after surgery, GCS （P= 0. 010）, GOS （P〈0. 001） of HBO group were significantly higher than those of control group, and the score of NIHSS was significantly lower （P〈 0. 001 ）. Conclusions HBO treatment could improve the curative effects on HICH patients after evacuation surgery of hematoma.