头针电刺激和高压氧的早期联合应用对高血压脑出血非手术患者认知障碍及脑水肿的影响

The effects of early combination of scalp-acupuncture electrical stimulation and hyperbaric oxygen on cognitive impairment and cerebral edema in non-surgical patients with hypertensive intracerebral hemorrhage

目的探讨早期联合应用头针电刺激和高压氧(HBO)对高血压脑出血非手术患者认知障碍及脑水肿的影响。方法选取2015年1月至2017年9月住院治疗的132例高血压脑出血患者,均伴有认知障碍,按随机数字表法分为A、B两组,A组67例采用常规治疗; B组65例,在常规治疗基础上于早期(入院3～5d)给予头针电刺激联合HBO治疗。比较入院第7、14 d血清S100β蛋白水平及脑水肿体积;第60 d评定总有效率、认知功能、偏瘫肢体运动功能及日常生活能力(ADL);治疗后高血压控制情况及不良反应发生率。结果 B组治疗后不同时间点(第7、14 d)的血清S100β蛋白含量及脑水肿体积明显优于A组;治疗后B组总有效率(89. 23%)高于A组(64. 18%);治疗第60 d,B组认知功能、偏瘫肢体活动功能及ADL均明显高于A组,差异均有统计学意义(P <0. 05)。两组血压控制效果及不良反应发生率比较,差异无统计学意义(P> 0. 05)。结论头针电刺激和高压氧早期联合应用治疗高血压脑出血非手术患者,能更好地改善认知功能,更快地消除脑水肿、提高总有效率。

Objective To explore the effect of early combination of scalp-acupuncture electrical stimulation and hyperbaric oxygen(HBO)on cognitive impairment and cerebral edema in patients with hypertensive intracerebral hemorrhage.Methods We selected 132 patients with hypertensive cerebral hemorrhage who suffered from cognitive impairment treated in our hospital from January 2015 to September 2017 as a study population.The patients were randomly divided into A and B groups.The group A(N=67)received routine treatment while the group B(N=65)was given scalp-acupuncture electrical stimulation and HBO treatment at early stage(admission of 3-5 days)on the basis of the routine treatment.The levels of serum S100βprotein and cerebral edema volume were compared on the 7th day and the 14th day after treatment.The total effective rate,cognitive function,hemiplegia limb motor function and daily living ability(ADL)were evaluated on the 60th day after treatment.The hypertension control and incidence of adverse reactions after treatment were also evaluated.Results The serum levels of S100βand cerebral edema volume at different time points(7d and 14d)after treatment in the group B were significantly lower than those in the group A(P<0.05).The total effective rate of the group B(89.23%)was higher than that of the group A(64.18%)(P<0.05).Compared with the group A,the group B had better improvement in cognitive function,hemiplegia limb motor function and ADL after 60 days of treatment(P<0.05).However,there was no significant difference in the blood pressure control and the incidence of adverse reactions between the two groups(P>0.05).Conclusions The early combination of scalp-acupuncture electrical stimulation and HBO in non-surgical patients with hypertensive intracerebral hemorrhage can better improve the cognitive function,faster eliminate the cerebral edema and improve the total effective rate.