缺血预适应训练对缺血性脑血管疾病患者脑氧代谢及血供状态的影响

Effects of ischemic pre adaptation training on cerebral oxygen metabolism and blood supply in patients with ischemic cerebrovascular disease

目的探讨缺血预适应训练对缺血性脑血管疾病患者脑氧代谢及血供状态的影响。方法选取阆中市人民医院七里院区2016年11月—2018年8月收治的缺血性脑血管疾病患者84例,采用随机数字表法分为对照组和观察组,各42例。对照组进行常规治疗,观察组在对照组基础上进行缺血预适应训练。两组均治疗12个月。比较两组治疗前和治疗后3、6、12个月颈静脉球血氧饱和度(SjvO2)、脑氧摄取率(O2ER)、动脉内氧含量(CaO2)、收缩期峰值流速(PSV)、阻力指数(RI)、搏动指数(PI)、不良反应发生率。结果治疗前两组SjvO2、O2ER、CaO2比较,差异无统计学意义(P>0.05);治疗后3、6、12个月观察组SjvO2高于对照组,O2ER、CaO2低于对照组(P<0.05)。治疗前两组颈内动脉、椎动脉PSV、RI、PI比较,差异无统计学意义(P>0.05);治疗后3、6、12个月观察组椎动脉、颈内动脉PSV高于对照组,RI、PI低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论缺血预适应训练可有效改善缺血性脑血管疾病患者脑氧代谢及血供状态,且安全性较高。

Objective To explore the effect of ischemic pre adaptation training on cerebral oxygen metabolism and blood supply in patients with ischemic cerebrovascular disease.Methods A total of 84 cases of patients with ischemic cerebrovascular disease were selected from November 2016 to August 2018 in Qili District Langzhong People’s Hospital,which were divided into control group and observation group according to random number table,42 cases in each group.The control group received routine treatment,and the observation group received ischemic pre adaptation training based on the the control group.Both groups were treated for 12 months.The blood oxygen saturation(SjvO2),oxygen uptake rate(O2 ER),arterial oxygen content(CaO2),peak systolic velocity(PSV),resistance index(RI),pulsatility index(PI)and adverse reactions were compared before and 3,6 and 12 months after treatment.Results There was no significant difference in SjvO2,O2 ER and CaO2 between the two groups before treatment(P>0.05);3,6 and 12 months after treatment,the observation group of the SjvO2 was higher than the control group,the O2 ER and CaO2 were lower than the control group(P<0.05).There was no significant difference in PSV,RI and PI of vertebral artery and internal carotid artery between the two groups before treatment(P>0.05);3,6 and 12 months after treatment,the observation group PSV of vertebral artery and internal carotid artery was higher than the control group,RI and PI were lower than the control group(P<0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Ischemic pre adaptation training can significantly improve cerebral oxygen metabolism and blood supply in patients with ischemic cerebrovascular disease,and with high safety.