早期高压氧治疗对脑出血后抑郁患者的影响

The effect of early hyperbaric oxygen therapy on patients with depression after intracerebral hemorrhage

目的 探讨脑出血后抑郁患者开展早期高压氧治疗对其抑郁程度,心理韧性和单胺类神经递质水平的影响。方法 于2020年1月~2022年12月采集病例资料入档,对象为医院收治的高血压脑出血后抑郁患者共计120例,纳入对象基于“随机数字表法”1:1分组,划分为对照组(应用常规药物治疗)与观察组(予以常规药物+早期高压氧治疗),各组纳入60例;观察对比两组抑郁程度、心理韧性、神经功能缺损及肢体运动功能、单胺类神经递质水平。结果 与对照组相比,观察组治疗2周、4周的17项-汉密尔顿抑郁量表(Hamilton depression scale-17,HAMD-17)评分显著低(P<0.05);治疗后,两组心理弹性量表(Connor-Davidson resilience scale,CD-RISC)评分呈不同程度的升幅,且观察组升幅更大(P<0.05);干预后,两组Fugl-meyer运动功能量表(FuglMeyer motor function assessment,FMA)评分均升高,美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分均下降,且观察组更优(P<0.05);治疗后,两组去甲肾上腺素(norepinephrine,NE)、5-羟色胺(5-hydroxytryptamine,5-HT)、多巴胺(Dopamine,DA)水平均升高,且观察组更高(P<0.05)。结论 高血压脑出血后抑郁患者开展高压氧治疗,可有效调节单胺类神经递质水平,有效改善患者抑郁程度,同时改善神经功能及肢体功能,增强其心理韧性,取得良好预后。

Objective To explore the effect of early hyperbaric oxygen therapy on the degree of depression,psychological resilience,neurological deficit,limb motor function and monoamine neurotransmitter level in patients with depression after intracerebral hemorrhage.Method Case data were collected and filed from January 2020 to December 2022.A total of 120 patients with depression after hypertensive intracerebral hemorrhage admitted to the hospital were included.The participants were divided into a control group(treated with conventional drugs)and an observation group(treated with conventional drugs and early hyperbaric oxygen)based on a 1:1 random number table method,with 60 patients in each group;The depression degree,psychological resilience,neurological deficit,limb motor function and monoamine neurotransmitter level were observed and compared between the two groups.Results Compared with the control group,the observation group had significantly lower scores on the 17 items Hamilton Depression Scale-17(HAMD-17)after 2 and 4 weeks of treatment(P<0.05).After treatment,the scores of the Connor Davidson Resilience Scale(CD-RISC)showed varying degrees of increase in both groups,and the increase was greater in the observation group(P<0.05).After intervention,the Fugl Meyer motor function assessment(FMA)scores increased in both groups,while the National Institute of Health Stroke Scale(NIHSS)scores decreased in both groups,and the observation group showed better results(P<0.05).After treatment,the levels of norepinephrine(NE),5-hydroxytryptamine(5-HT),and dopamine(DA)increased in both groups,and were even higher in the observation group(P<0.05).Conclusion Hyperbaric oxygen therapy can effectively regulate the level of monoamine neurotransmitters,effectively improve the degree of depression in patients with depression after intracerebral hemorrhage,improve their neurological function and limb function,enhance their psychological resilience.