高压氧治疗急性大脑中动脉闭塞型脑梗死的单中心队列研究

Single center cohort study of hyperbaric oxygen therapy for acute middle cerebral artery occlusion cerebral infarction

目的 探讨急性大脑中动脉闭塞型脑梗死患者实施高压氧(hyperbaric oxygen,HBO)治疗的效果。方法 选择2017年1月至2021年6月在陆军第七十一集团军医院治疗的急性大脑中动脉闭塞型脑梗死患者,根据是否使用HBO治疗分为HBO组(HBO治疗+常规药物治疗,n=159)和对照组(常规药物治疗,n=314),比较两组患者治疗90d的良好功能预后率和90d病死率。结果 HBO组患者90d良好功能预后率高于对照组[50.9%(81/159)vs.40.4%(127/314),χ^(2)=4.721,P=0.030];HBO组90d病死率与对照组比较,差异无统计学意义[3.8%(6/159)vs. 3.5%(11/314),χ^(2)=0.022,P=0.881]。结论 早期使用HBO治疗急性大脑中动脉闭塞型脑梗死患者,能显著改善其预后且不增加患者病死率,证明HBO治疗急性大脑中动脉闭塞型脑梗死患者安全且有效。

Objective To investigate the effect of hyperbaric oxygen therapy(HBO) in patients with acute middle cerebral artery occlusion. Methods Patients with acute middle cerebral artery occlusion treated in the 71st Army Hospital from January 2017 to June 2021 were selected and divided into HBO group(HBO + conventional drug therapy, n=159) and control group(conventional drug therapy, n=314) according to whether they received HBO. The 90-day good functional prognosis [modified Rankin Score(mRS) ≤2 points] and the 90-day mortality were compared between the two groups. Results The 90-day good functional prognosis of cerebral infarction patients in HBO group was higher than that in control group [50.9%(81/159) vs.40.4%(127/314), χ^(2)=4.721, P=0.030]. There was no significant difference in 90d mortality between the HBO group and the control group [3.8%(6/159) vs. 3.5%(11/314), χ^(2)=0.022, P=0.881]. Conclusion Early use of HBO in the treatment of patients with acute middle cerebral artery occlusion can significantly improve their functional prognosis without increasing the mortality rate. Therefore, the application of HBO in patients with acute anterior circulation cerebral infarction is safe and effective.