高压氧疗法对高血压脑出血患者术后脑血管动力学及脑水肿的影响

Effects of hyperbaric oxygen therapy on post-operative cerebral vascular dynamics and brain edema in patients with hypertensive cerebral hemorrhage

目的观察高压氧疗法对高血压脑出血患者术后脑血管动力学及脑水肿的影响。方法选取2015-04～2017-03于该院治疗的高血压脑出血术后患者78例作为研究对象,采用随机数字表法将其分为两组,各39例。对照组给予临床常规治疗,观察组则在常规治疗基础上加以高压氧疗法治疗。观察两组治疗前后脑血管动力学相关指标及脑水肿体积。结果治疗前两组平均流速(Vmean)、平均流量(Qmean)、外周阻力(peripheral resistance,PR)、动态阻力(dynamic resistance,DR)对比,差异无统计学意义(P> 0. 05);治疗后观察组Vmean、Qmean高于对照组,PR、DR低于对照组,差异有统计学意义(P <0. 05);治疗后3 d两组脑水肿体积比较,差异无统计学意义(P> 0. 05);治疗后14 d、28 d观察组脑水肿体积小于对照组,差异有统计学意义(P <0. 05)。结论高压氧疗法有助于促进高血压脑出血患者术后脑血管动力学的改善,减轻脑水肿程度,利于提升临床疗效,改善预后。

Objective To observe the effects of hyperbaric oxygen therapy on post-operative cerebral vascular dynamics and brain edema in patients with hypertensive cerebral hemorrhage. Methods Seventy-eight patients with hypertensive intracerebral hemorrhage treated in our hospital from April 2015 to March 2017 were selected as the research subjects and were divided into two groups by the random number table method. The control group（ n =39） was given routine clinical treatment, and the observation group（ n =39） was treated with hyperbaric oxygen therapy crmbined with routine clinical treatment. The post-operative cerebrovascular dynamics and brain edema volume were compared between the two groups. Results There were no significant differences in the mean flow velocity（Vmean）, mean flow rate（Qmean）, peripheral resistance（PR） and dynamic resistance（DR） between the two groups before treatment（ P 〉0.05）. There was no significant difference in the volume of brain edema between the two groups 3 days after treatment（ P 〉0.05）. The Vmean and Qmean of the observation group was significantly higher than that of the control group, and the PR and DR of the observation group was significantly lower than that of the control group（ P 〈0.05）. The brain edema volume of the observation group was significantly smaller than that of the control group 14 and 28 days after treatment（ P 〈0.05）. Conclusion Hyperbaric oxygen therapy can promote the improvement of cerebral vascular hemodynamics, reduce the degree of cerebral edema and improve the prognosis in the patients with hypertensive intracerebral hemorrhage.