高压氧治疗对腹膜透析伴认知功能障碍患者疗效及生活质量的影响

Efficacy of hyperbaric oxygen on peritoneal dialysis patients with cognitive impairment and its impact on quality of life

目的分析高压氧治疗对腹膜透析伴认知功能障碍患者疗效及生活质量的影响。方法将2019年12月至2020年12月临沂市中心医院收治的120例伴有认知功能障碍的维持性腹膜透析患者按照随机数字表法分为观察组和对照组各60例。2组患者均接受腹膜透析等终末期肾脏病常规治疗,对照组接受认知功能训练,观察组在对照组基础上给予高压氧治疗,比较2组患者治疗前后认知功能及生活质量的变化。结果2组患者治疗前后血尿素氮(BUN)、肌酐(Scr)、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、pH值差异无统计学意义(P>0.05);治疗后2组患者血红蛋白(Hb)均较治疗前明显升高,差异具有统计学意义(P<0.05),组间比较差异无统计学意义(P>0.05);治疗后,2组患者Addenbrooke改良认知评估量表(ACE-R)各指标评分及总分均较治疗前显著增高,且观察组高于对照组,差异均有统计学意义(P<0.05);观察组患者血清脑源性神经营养因子(BDNF)水平较治疗前显著升高,2组患者血清同型半胱氨酸(Hcy)、C反应蛋白(CRP)水平较治疗前显著降低,且观察组低于对照组,差异均有统计学意义(P<0.05);2组患者生活质量指标均较治疗前显著改善,且观察组高于对照组,差异均有统计学意义(P<0.05);2组患者治疗期间不良事件发生率比较,差异无统计学意义(P>0.05)。结论高压氧治疗能够显著改善腹膜透析患者的认知功能,提高其生活质量,且安全可靠,值得临床推广。

Objective To analyze the effect of hyperbaric oxygen therapy on peritoneal dialysis(PD)patients with cognitive impairment and its impact on quality of life.Methods A total of 120 maintenance PD patients with cognitive impairment admitted to Linyi Central Hospital from December 2019 to December 2020 were divided into observation group and control group according to the random number table method,with 60 cases in each group.Patients in both groups received conventional treatments including PD for end-stage renal disease.The control group received cognitive training,and the observation group received hyperbaric oxygen therapy on the basis of the training of the control group.The changes of cognitive function and quality of life of the patients in the two groups were compared.Results There was no significant difference in the levels of BUN,Scr,PaO_(2),PaCO_(2),and pH between the two groups before and after treatment(P>0.05).After treatment,Hb levels in the two groups were significantly higher than those before treatment,with statistically significant differences(P<0.05),while there was no statistically significant difference between the two groups(P>0.05).After treatment,the Addenbrooke’s Cognitive Examination-Revised(ACE-R)total score and sub-scale scores of patients in both groups were significantly increased than those before treatment,with statistically significant differences(P<0.05),and those scores in the observation group were significantly higher than those in the control group,with statistically significant differences(P<0.05).The serum BNDF level of the observation group was significantly higher than that before treatment.The serum Hcy and CRP levels of the two groups were significantly lower than those before treatment,with statistically significant differences(P<0.05),and those two levels of the observation group were significantly lower than those of the control group,with statistically significant differences(P<0.05).The indicators of quality of life in the two groups were significantly improved than those before treatment,with statistically significant differences(P<0.05),and the indicators of the observation group were better than those of the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in the incidence of adverse events between the two groups during treatment(P>0.05).Conclusion Hyperbaric oxygen therapy can significantly improve the cognitive function and quality of life of PD patients,and it is safe and reliable,which is worthy of clinical promotion.