高压氧配合电针对中老年高血压脑出血认知障碍患者疗效的影响

Effects of Hyperbaric Oxygenation Combined with Electro-acupuncture on Cognitive Impairment in Middle-Aged and Elderly Patients with Hypertensive Cerebral Hemorrhage

【目的】探讨高压氧配合电针对中老年高血压脑出血认知障碍患者的治疗效果。【方法】选取129例中老年高血压脑出血认知障碍患者,按分层随机法将患者随机分为观察组和对照组,对照组64例,观察组65例。对照组给予常规脑出血基础治疗,并于入院第3~5天起给予电针治疗。观察组在对照组的基础上于入院第3~5天起给予高压氧治疗。治疗10次为1个疗程,2组均连续治疗4个疗程。治疗60 d后,观察2组患者治疗前与治疗后第7、14、21、60天血清神经元特异性烯醇化酶(NSE)含量、认知障碍评分以及脑水肿绝对体积和脑水肿相对体积的变化情况,以及主要并发症的发生情况,并评价2组患者的临床疗效。【结果】(1)观察组总有效率为90.77%(59/65),对照组为76.56%(49/64)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗第14、21天,2组患者的血清NSE含量均明显改善(P<0.05),且观察组优于对照组,差异均有统计学意义(P<0.05)。治疗后第60天,2组患者NSE含量均已恢复至正常水平。(3)治疗后,2组患者认知障碍评分均明显改善(P<0.05),且观察组在改善认知障碍评分方面均明显优于对照组(P<0.05)。(4)治疗后第14、21天,2组患者脑水肿绝对体积、脑水肿相对体积均明显改善(P<0.05),且观察组的改善效果明显优于同期对照组,差异有统计学意义(P<0.05)。治疗后第60天观察,2组患者的脑水肿均已完全吸收。(5)研究过程中,对照组并发症发生率为12.50%(8/64);观察组并发症发生率为13.85%(9/65)。2组患者并发症发生率比较,差异无统计学意义(P>0.05)。研究过程中,对照组患者出现一过性心悸2例,观察组患者出现轻微呼吸困难者3例,均未给予特殊处理,休息后均自行缓解。【结论】高压氧配合电针治疗中老年高血压脑出血认知障碍,能够明显提高患者认知功能,改善脑水肿状况,临床疗效显著。

Objective To observe the therapeutic effects of hyperbaric oxygenation combined with electroacupuncture for cognitive impairment in middle-aged and elderly patients with hypertensive cerebral hemorrhage.Methods One hundred and twenty-nine middle-aged and elderly patients with cognitive impairment after hypertensive cerebral hemorrhage were divided into observation group and control group,64 cases in control group and 65 cases in observation group,using stratified random sampling method. Both groups received routine basic treatment for cerebral hemorrhage,plus electro-acupuncture treatment from day 3 to 5 after hospital admission,additionally, the observation group received hyperbaric oxygenation treatment from day 3 to 5 after hospital admission. Ten times constituted one treatment course, and the treatment covered 4 courses. After 60-day treatment,the changes in serum neuron-specific enolase(NSE)content,cognitive impairment scores,absolute volume and relative volume of cerebral edema,and incidence of major complications were observed in the two groups before and after treatment,and the clinical efficacy was evaluated. Results(1)The total clinical response rate in the observation group was 90.77%(59/65),and that in the control group was 76.56%(49/64). The clinical efficacy of the observation group was superior to that of the control group(P < 0.05).(2)On day 14, 21 of treatment, the serum NSE content of the two groups was improved(P<0.05), and the improvement of the observation group was superior to that of the control group(P < 0.05). On day 60 of treatment,the serum NSE content of the two groups was raised to the normal level.(3)After treatment,the cognitive impairment scores of the two groups were improved(P<0.05), and the improvement in cognitive impairment scores of the observation group was superior to that of the control group(P < 0.05).(4)On day 14,21 of treatment,the absolute volume and relative volume of cerebral edema of the two groups were improved(P<0.05),and the improvement of the observation group was superior to that of the control group(P < 0.05). On day 60 of treatment,the cerebral edema of the two groups was absorbed.(5)During trial,the incidence of major complications in the control group was12.50%(8/64), and that in the observation group was 13.85%(9/65). There was no significant difference in incidence of major complications between the two groups(P>0.05). During trial,2 cases of transient palpitation occurred in the control group,and 3 cases of mild dyspnea in the observation group. They received no special treatment, and recovered by themselves after rest. Conclusion Hyperbaric oxygen combined with electroacupuncture is effective for treating cognitive impairment in middle-aged and elderly patients with hypertensive cerebral hemorrhage,and can significantly promote cognitive function and improve cerebral edema.