高压氧对不完全性脊髓损伤患者认知功能和焦虑抑郁情绪的影响

Effects of hyperbaric oxygen on cognitive function, anxiety and depression in patients with incomplete spinal cord injury

目的探讨高压氧对不完全性脊髓损伤患者认知功能和焦虑抑郁情绪的影响。方法抽取2017年6月至2019年12月在郑州大学第一附属医院就诊的不完全性脊髓损伤患者115例。使用抛硬币法将其随机分为高压氧组59例和常规组56例。两组患者均给予常规康复治疗,高压氧组在常规康复治疗基础上给予高压氧治疗,连续治疗8周,并于治疗前、治疗4周末、治疗8周末、治疗12周末分别给予精神分裂症认知功能成套测验(MCCB)、汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评定。结果本研究高压氧组脱落2例,常规组脱落1例。治疗前,两组认知功能7大领域评分及HAMD、HAMA评分比较差异未见统计学意义(P>0.05)。治疗后,两组患者词语学习、信息处理速度、注意/警觉性、工作记忆、推理和问题解决评分随着治疗时间的延长均逐渐升高,且高压氧组上述评分上升幅度高于常规组(P<0.05);视觉学习、社会认知评分随着治疗时间的延长也均逐渐上升,但两组间比较差异未见统计学意义(P>0.05)。治疗后,随着治疗时间的延长,HAMD、HAMA评分逐渐下降,且高压氧组评分下降幅度大于常规组(P<0.05)。结论高压氧治疗能进一步改善不完全性脊髓损伤患者的认知功能和焦虑抑郁症状,有助于患者的预后。

Objective To observe the effects of hyperbaric oxygen on cognitive function,anxiety and depression state of patients with incomplete spinal cord injury.Methods A total of 115 patients with ncomplete spinal cord injury treated in the First Affiliated Hospital of Zhengzhou University from June 2017 to December 2019 were selected as the research objects.By using coin tossing method,they were divided into hyperbaric oxygen group(59 cases)and conventional group(56 cases).Both groups were given the same conventional rehabilitation treatment,while hyperbaric oxygen group was given hyperbaric oxygen treatment on the basis of conventional rehabilitation,both groups were treated for 8 weeks.Before treatment,at the end of 4,8 and 12 weeks after treatment,the patients were assessed with the MATRICS Consensus Cognitive Battery(MCCB),Hamilton Depression Scale(HAMD-17)and Hamilton Anxiety Scale(HAMD-14).Results In the study,2 cases in the hyperbaric oxygen group were expulsed,and 1 case in the conventional group was expulsed.Before treatment,there was no significant difference in cognitive function score,HAMD-17 score and HAMA-14 score between the two groups(P>0.05).After treatment,the scores of Hopkins Verbal Learning Test score,information processing standard operating procedure,continuous performance test-identical pairs version,working memory scaleⅢand ability of ratiocination and resolving question of the two groups increased gradually with the extension of treatment time,and the increase rate of hyperbaric oxygen group was greater than that of the conventional group(P<0.05).Visual learning and social cognition score increased gradually with the extension of treatment time,but there was no statistical significance between the two groups(P>0.05).After treatment,the scores of HAMD and HAMA decreased gradually with the extension of treatment time,and the decrease of scores in hyperbaric oxygen group was greater than that in the conventional group(P<0.05).Conclusions Hyperbaric oxygen therapy can further improve cognitive function and anxiety and depression symptoms of patients with incomplete spinal cord injury,which is conducive to the prognosis of patients.