高压氧治疗急性脑梗死伴颈动脉粥样硬化的临床观察

Clinical effects of hyperbaric oxygen on acute cerebral infarction complicated with carotid atherosclerosis

目的 观察高压氧（hyperbaric oxygen,HBO）治疗在急性脑梗死（acute cerebral infarction,ACI）伴颈动脉粥样硬化（carotid atherosclerosis,CAS）的临床效果.方法 选择2015年2月至2017年2月宿州市立医院神经内科收治的ACI伴CAS患者100例,按照治疗方法分为HBO组和对照组,同时选取50例健康者作为健康组.对照组给予常规治疗,HBO组在常规治疗的基础上给予HBO治疗,比较2组患者治疗前后的有效率.分析比较3组患者治疗前后欧洲脑卒中量表（European stroke scale,ESS）评分、Barthel指数评分及血浆同型半胱氨酸（homocysteine,Hcy）水平.结果 治疗3个疗程后,HBO组治疗有效率（88.0％）明显高于对照组（70.0％）,差异有统计学意义（P＜0.05）.HBO组ESS评分降低,Barthel指数评分增加,与对照组比较差异有统计学意义（P＜0.05）;治疗后HBO组血浆Hcy水平明显低于对照组,差异有统计学意义（P＜0.05）,而与健康组比较差异无统计学意义（P＞0.05）;治疗后有效组血浆Hcy水平明显低于无效组,差异有统计学意义（P＜0.05）.结论 HBO治疗可明显提高ACI伴CAS的临床疗效,血浆Hcy对HBO治疗ACI伴CAS具有较好的评估价值,可为其诊断和治疗提供一条新思路.

Objective To observe clinical therapeutic effects of hyperbaric oxygen （HBO） on acute cerebral infarction （ACI） complicated with carotid atherosclerosis （CAS）.Methods One hundred patients with ACI complicated with CAS who were admitted for treatment in the hospital from February 2015 to February 2017 were chosen as research subjects.The patients were divided into the HBO group and the control group in accordance with different treatment methods,and at the same time,50 healthy subjects were recruited as the normal healthy group.The control group was given routine treatment,while the HBO group received HBO in addition to routine treatment.Therapeutic effects were compared between the 2 groups,before and after treatment.Then,scores of European stroke scale （ESS）,Barthel index （BI） and homocysteine （Hcy） before and after treatment were evaluated and compared between the 3 groups.Results After 3 treatment courses,the therapeutic efficacy of the HBO group （88.0％） was obviously higher than that of the control group （70.0％）,with statistical significance （P ＜0.05）.The ESS scores of the HBO group were decreased and the BI levels were increased,and statistical significance could be seen,when they were compared with those of the control group（P ＜ 0.05）.After treatment,the plasma Hcy levels for the HBO group were significantly lower than those of the control group,also with statistical significance （P ＜ 0.05）.However,there was no statistical significance,when they were compared with those of the normal healthy group（P ＞ 0.05）.After treatment,the plasma Hcy levels of the effective group was obviously lower than that of the non-effective group （P ＜ 0.05）.Conclusions HBO treatment could obviously improve the clinical effects on acute cerebral infarction complicated with carotid atherosclerosis.Plasma Hcy level showed high clinical value in HBO treatment of ACI complicated with CAS,and it might also provide new ideas for clinical diagnosis and treatment of the disorder.