高压氧治疗对大脑中动脉狭窄患者侧支循环及预后的影响

The effect of hyperbaric oxygen therapy on the middle cerebral artery of middle cerebral arteriarctia patients and the prognosis research

目的探析高压氧(HBO)治疗对大脑中动脉狭窄者侧支循环构建及预后情况的影响。方法分析2016年4月至2018年3月间在我院接受诊治的60例单侧大脑中动脉中度、重度血管狭窄的患者的临床资料,随机将患者分为观察组(药物联合HBO治疗)和对照组(单独药物治疗),每组30例。比较两组患者的一般资料、治疗前后大脑中动脉血流动力学情况、前交通动脉和后交通动脉开放情况及治疗6个月后缺血性卒中发生率及其严重程度。结果两组患者的一般资料、大脑动脉血流动力学、前后交通动脉开通率无明显统计学差异(P>0.05);治疗后,观察组患者的MCA Vd、Vs、Vm水平明显高于对照组,PI及RI值明显低于对照组(P<0.05);观察组患者前后交通动脉开通率明显高于对照组(P<0.05)。治疗6个月后,观察组患者的缺血性脑卒中发生率(6.7%)明显低于对照组(40.0%),NIHSS评分(4.35±1.65)明显低于对照组(5.41±1.74)(P<0.05)。观察组总有效率(90.0%)明显高于对照组(66.7%)(P<0.05)。结论 HBO治疗有助于大脑中动脉狭窄患者构建良好的侧支循环,改善其预后情况。

Objective To analyze the influence of hyperbaric oxygen therapy on the middle cerebral artery structure and prognosis of middle cerebral arteriarctia patients.Methods 60 patients with moderate and severe unilateral middle cerebral artery stenosis received treatment in our hospital from April, 2016 to March, 2018 was retrospectively analyzed.All patients were randomly divided into two groups, observe group (single drug training) and control group (drug combined with HBO therapy), 30 cases in each group.The general information, the hemodynamics of arteriae cerebri media before and after treatment, the occurrence rate and severity of ischemic stroke after 6 months of treatment in two groups were compared.Results The general information and the hemodynamics of arteriae cerebri media before treatment in two groups had no statistical difference ( P >0.05).After treatment, the levels of Vd, Vs, Vm in observe group were obviously lower than those in control group, and the PI and RI values in observe group were obviously higher than those in control group( P <0.05).After 6 months of treatment, the occurrence rate of ischemic stroke and NIHSS scores in observe group (40.0%, 5.41±1.74) were obviously higher than those in control group (6.7%, 4.35±1.65)( P <0.05).The total efficacy in control group (90.0%) was obviously higher than that in observe group (66.7%)( P <0.05).Conclusion The HBO treatment is helpful for the setting up of collateral circulation of patients with middle cerebral arteriarctia, and improving the prognosis.