不同时间扩血管治疗对神经系统减压病的疗效观察

Observation of the efficacy of vasodilation therapy at different time points on neurological decompression disorders

目的:观察血管扩张剂对神经系统减压病的治疗作用,通过临床对比,寻找最佳用药时机,为临床治疗提供指导依据。方法:应用回顾性随机单盲方法,按照发病到治疗的时间将166例急性神经系统减压病患者分为3组,分别为A组(<6 h)45例、B组(6~24 h)79例、C组(>24~72 h)42例,每组按照加压治疗基础上是否增加扩血管药物治疗再分为治疗组和对照组,应用欧洲卒中量表(ESS),Barthel指数(BI)评价神经功能变化情况。结果:治疗后,3组中的治疗组ESS分值均高于对照组,差异有统计学意义( P<0.05),随着治疗时间的延长,组间差异程度逐渐增大;治疗组的致残率明显低于对照组;治疗组的恢复率明显高于对照组;治疗越早,致残率越低,痊愈率越高。 结论:加压吸氧联合扩血管药物治疗急性神经系统减压病的效果明显优于单独加压吸氧治疗,并且治疗时间越早疗效越好。

ObjectiveTo observe the therapeutic effects of vasodilators on neurogenic decompression sickness,and to identify the optimal timing of drug administration through clinical comparison,thereby providing guidance for clinical treatment.MethodsThe prospective randomized single-blind method was employed to categorize 166 patients with acute neurogenic decompression sickness,based on the time from onset to treatment,into three groups:Group A(≤6 hours)with 45 cases,Group B(6-24 hours)with 79 cases,and Group C(>24-72 hours)with 42 cases.Each group was further divided into treatment and control subgroups based on whether vasodilation therapy was added besides hyperbaric oxygen therapy.Neurological functional changes were evaluated using the European stroke scale(ESS)and the Barthel index(BI).ResultsAfter treatment,the treatment subgroups in all three groups showed higher ESS scores compared with the control subgroups,with statistically significant inter-group differences in the later stages(P<0.05).The inter-group difference increased as the treatment duration prolonged.The disability rates in the treatment subgroups were significantly lower than those in the control subgroups,and the recovery rates were also significantly higher.Furthermore,the earlier the treatment adopted,the lower the disability rate and the higher the recovery rate achieved.ConclusionThe combined treatment of hyperbaric oxygen therapy with vasodilators for acute neurogenic decompression sickness demonstrates significantly superior efficacy compared with using hyperbaric oxygen therapy alone,with earlier treatment yielding better outcomes.