The Effect of Different Hyperbaric Oxygen Treatment Time Windows on Neurological Function and Prognosis in Acute Cerebral Infarction

Objective:To observe the effects of different hyperbaric oxygen treatment time windows on the prognosis and neurological function of acute cerebral infarction.Method:160 patients with acute cerebral infarction admitted to Xiangyang Central Hospital in Hubei Province were randomly divided into four groups,each with 40 cases,using a random number table method.According to the 2017 guidelines for the treatment of cerebral infarction,the control group received routine treatment for acute cerebral infarction;On the basis of the control group,patients in Group A received hyperbaric oxygen therapy within 48 hours of onset;Group B patients receive hyperbaric oxygen therapy within 3-6 days of onset;Group C patients receive hyperbaric oxygen therapy within 7-12 days of onset.Observe the efficacy,recurrence,and neurological function recovery of four groups of patients after treatment.Result:There was no statistically significant difference in the National Institutes of Health Stroke Scale(NIHSS)and Barthel Index(BI)scores among the four groups before treatment(P>0.05).There were statistically significant differences in NIHSS and BI scores between 14 and 30 days after treatment and before treatment(F=16.352,27.261,11.899,28.326,P<0.05).At 14 and 30 days after treatment,the NIHSS score in Group A decreased compared to the control group,Group B,and Group C,while the BI score increased compared to the control group,Group B,and Group C,with statistical significance(P<0.05).There was no statistically significant difference in NIHSS and BI scores between Group C and the control group after treatment(P>0.05).After 30 days of treatment,the total effective rate of Group A was higher than that of the control group and Group C,and the difference was statistically significant(X2=6.135,P<0.05).The one-year recurrence rate of Group A and Group B is lower than that of Group C and the control group,and the difference is statistically significant(X2=8.331,P<0.05).There was no statistically significant difference in adverse reactions among the four groups(P>0.05).Conclusion:Patients with acute cerebral infarction who receive hyperbaric oxygen therapy within 48 hours can improve neurological function and reduce the recurrence rate.The efficacy of receiving hyperbaric oxygen therapy within 7-12 days of onset is equivalent to that of not receiving hyperbaric oxygen therapy.

Neuroprotective effect of high-dose hyperbaric oxygenation on rats with acute cerebral infarction in super-early stage:Curative comparison between 9-hour and 18-hour therapeutic protocols

BACKGROUND： Previously, only single short-time low-dose hyperbaric oxygenation （HBO） protocol was administrated to treat acute ischemic stroke in early stage and the conflicting results were obtained. There are few studies to report the outcome of administering long-time （can cover all the natural pathologic progression period） high-dose HBO to treat the disease. OBJECTIVE： To evaluate the therapeutic effect between two kinds of high-dose hyperbaric oxygenation on super-early stage of acute permanent middle cerebral artery occlusion （MCAO） in rats. DESIGN： A randomized controlled experimental study. SETTING： Beijing Tiantan Hospital, Capital Medical University; Beijing Research Institute of Neurosurgery. MATERIALS： Seventy-four male SD rats, aged 2.5 months old, weighing （ 280 ＋ 20） g, were provided by the Animal Institute, Chinese Academy of Medical Sciences. Hyperbaric oxygenation device was hyperbaric air cabin in which there was a self-made pure oxygen animal experimental cabin （made in China）. METHODS： This experiment was carried out in the municipal laboratory of Beijing Tiantan Hospital affiliated to Capital Medical University and Beijing Research Institute of Neurosurgery. ① Experimental intervention： All the rats were developed into models of permanent MCAO by suture embolism. Then, they were randomly divided into two HBO groups （9 hours and 18 hours） and control group, with 24 rats in each as well as 3-hour ultrastructure control group, with 2 rats. After being modeled for 3 hours, rats in the two HBO groups stayed in the hyperbaric cabin for 9 hours and 18 hours, separately. Rats in the 9-hour HBO group inhaled pure oxygen at hours 1, 3, 5, 7 and 9, and hyperbaric air at hours 2, 4, 6 and 8. Rats in the 18-hour HBO group inhaled pure oxygen at hours l, 3, 5, 7, 9, 11, 13, 15 and 17, and hyperbaric air at hours 2, 4, 6, 8, l0 12, 14, 16 and 18. After being created into models, rats in the control group and 3-hour ultrastructure control group breathed room air. ② Experimental evaluation： Neurologic functions of rat models in the 9-hour and 18-hour HBO groups as well as control group were scored by Bederson and Garica two neurological grading systems at hours 14 and 28 and on day 5; Infarct volume of rat models in the two HBO groups and control group was measured at hour 24 and on day 5 with NIH image processing software Image J; The pathological changes of brain tissue in the brain infarct region and its opposite region of rat models in the two HBO groups and 3-hour ultrastructure control group were observed with a Philips EM 208S transmission electron microscope. MAIN OUTCOME MEASURES： ① Neurobehavioral outcome. ② Rat brain infarct volume. ③ Ultrastructure of brain tissue in the ischemic penumbra of infarct models at the different time points RESULTS： ① Neurobehavioral outcome： After treatment, Garica score in the 9-hour and 18-hour HBO groups was significantly higher than that in the control group （P 〈 0.01）. Bederson score on day 5 after modeling in the 9-hour and 18-hour HBO groups was significantly lower than that in the control group （P 〈 0.01）. ② Cerebral infarct volume： Cerebral infarct volume in the 9-hour and 18-hour HBO groups was significantly smaller than that in the control group at hour 24 and on day 5 after modeling （P 〈 0.01）. In the 18-hour HBO group, infarct volume on day 5 after modeling was significantly larger than that at hour 24 after modeling （P 〈 0.05）. ③In the 3-hour ultrastructure control group, astrocyte edema and neuron damage around the capillary in the infarct cerebral tissue significantly relieved in the rats which were subjected to HBO. CONCLUSION： High dose of HBO is highly efficient in reducing infarct volume and improving neurobehavioral outcome of rats with acute cerebral infarction, and also has an important role in inhibiting the pathological progression of ischemic brain tissue after cerebral infarction.

Effects of emergency hyperbaric oxygen therapy on nerve injury, angiogenesis and cerebral blood perfusion in patients with acute cerebral infarction

Objective:To explore the effects of emergency hyperbaric oxygen therapy on nerve injury, angiogenesis and cerebral blood perfusion in patients with acute cerebral infarction.Methods:A total of118 patients with acute cerebral infarction who were treated in the hospital between April 2015 and October 2017 were selected as study subjects and divided into hyperbaric oxygen group (n=59) and control group (n=59) by random number table method. Control group received conventional therapy, hyperbaric oxygen group received conventional therapy combined with hyperbaric oxygen therapy, and both groups were treated for 2 weeks. The differences in nerve injury, angiogenesis and cerebral blood perfusion were compared between the two groups before and after treatment.Results: Differences in nerve injury, angiogenesis and cerebral perfusion were not significant between the two groups immediately after diagnosis. After 2 weeks of treatment, serum nerve injury indexes IGF-1, Copeptin, PAO, AQP4 and H-FABP contents of hyperbaric oxygen group were lower than those of control group;serum angiogenesis indexes PEDF, Ang-1 and VEGF contents were higher than those of control group whereas ES content was lower than that of control group;stenotic-side cerebral blood perfusion parameters CBF and CBV levels were higher than those of control group whereas TTP level was lower than that of control group.Conclusion: Emergency hyperbaric oxygen therapy can effectively reduce nerve injury, promote cerebral angiogenesis and increase cerebral blood perfusion in patients with acute cerebral infarction.

Changes in serum cellular adhesion molecule and matrix metalloproteinase-9 levels in patients with cerebral infarction following hyperbaric oxygen therapy A case and intergroup control study

BACKGROUND： Animal studies have confirmed that hyperbaric oxygen （HBO） therapy can reduce matrix metalloproteinase activity and blood brain barrier permeability, thereby exhibiting neuroprotective effects. However, at present, consensus does not exist in terms of its clinical efficacy. OBJECTIVE： To validate the significance of changes in serum cellular adhesion molecule and MMP-9 levels in patients with cerebral infarction following HBO therapy. DESIGN, TIME AND SETTING： This randomized, controlled, neurobiochemical study was performed at the Department of Neurology, Affiliated Hospital of Qingdao University Medical College between December 2002 and March 2006. PARTICIPANTS： A total of 112 patients with acute cerebral infarction of internal carotid artery, comprising 64 males and 48 females, averaging （67 ±11） years, were recruited and randomized to a HBO group （n = 50） and a routine treatment group （n = 62）. An additional 30 gender- and age-matched normal subjects, consisting of 17 males and 13 females, averaging （63 ± 9） years, were enrolled as control subjects. METHODS： The routine treatment group received routine drug treatment and rehabilitation exercise. HBO treatment was additionally performed in the HBO group, once a day, for a total of 10 days. MAIN OUTCOME MEASURES： Serum levels of soluble intercellular adhesion molecule, soluble vascular cell adhesion molecule, soluble E-selectin, and matrix metalloproteinase-9 were detected by enzyme linked immunosorbent assay. RESULTS： Upon admission, serum levels of soluble intercellular adhesion molecule, soluble vascular cell adhesion molecule, soluble E-selectin, and matrix metalloproteinase-9 were significantly increased in patients with cerebral infarction, compared with control subjects （P 〈 0.01）. Following HBO and routine treatments, serum levels of the above-mentioned indices were significantly reduced in the HBO and routine treatment groups （P 〈 0.01）. Moreover, greater efficacy was observed in the HBO group, compared with the routine treatment group （P 〈 0.05 or P 〈 0.01）. CONCLUSION： Intergroup comparison and case-control results indicated that HBO noticeably reduced serum levels of soluble intercellular adhesion molecule, soluble vascular cell adhesion molecule, soluble E-selectin, and matrix metalloproteinase-9.

Effect of rehabilitation training combined with hyperbaric oxygen therapy on the nerve cytokine secretion and oxidative stress in rehabilitation period of patients with cerebral infarction

Objective: To discuss the influence of rehabilitation training combined with hyperbaric oxygen therapy on the nerve cytokine secretion and oxidative stress in rehabilitation period of patients with cerebral infarction. Methods: A total of 110 patients with cerebral infarction who received rehabilitation therapy in the hospital between January 2015 and May 2017 were divided into routine group (n=55) and hyperbaric oxygen group (n=55) according to random number table. Routine group received regular rehabilitation training, and hyperbaric oxygen group underwent rehabilitation training combined with hyperbaric oxygen therapy. The differences in the serum contents of nerve factors, neurotransmitters and oxidative stress indexes were compared between the two groups at immediately after admission (T0) and after 14 d of treatment (T1). Results: At T0, there was no statistically significant difference in the serum contents of nerve factors, neurotransmitters and oxidative stress indexes between the two groups. At T1, serum nerve factors MBP and NSE contents of hyperbaric oxygen group were lower than those of routine group while NGF content was higher than that of routine group;serum neurotransmitter Glu content was lower than that of routine group while GABA content was higher than that of routine group;serum oxidative stress indexes ROS and LHP contents were lower than those of routine group while CAT and SOD contents were higher than those of routine group. Conclusion: Rehabilitation training combined with hyperbaric oxygen therapy can effectively optimize the nerve function and inhibit the systemic oxidative stress response in rehabilitation period of patients with cerebral infarction.

Effect of gangliosides combined with hyperbaric oxygenation on neural functional recovery and oxidative stress injury after cerebral infarction intervention

Objective:To explore the effect of gangliosides combined with hyperbaric oxygenation on neural functional recovery and oxidative stress injury after cerebral infarction intervention. Methods:A total of 120 patients with cerebral infarction who received interventional therapy in our hospital between August 2013 and February 2016 were collected and divided into control group and observation group, 60 cases in each group. Control group received hyperbaric oxygenation after intervention, and the observation group received gangliosides combined with hyperbaric oxygenation after intervention. The differences in serum levels of neurotrophy indexes, nerve injury indexes and oxidative stress indexes were compared between two groups of patients before and after treatment.Results: Before intervention, differences in serum levels of neurotrophy indexes, nerve injury indexes and oxidative stress indexes were not statistically significant between two groups of patients. After intervention, serum neurotrophy indexes BDNF and NT-3 levels in observation group were higher than those in control group;serum nerve injury indexes S100B, NGB, NSE and GFAP levels were lower than those in control group;serum oxidative indexes MDA, MPO and LPO levels were lower than those in control group while antioxidant indexes SOD, GSH-Px, CAT and TAC levels were higher than those in control group.Conclusion: Gangliosides combined with hyperbaric oxygenation for patients with cerebral infarction after interventional therapy helps speed up the neural functional recovery and also reduce systemic inflammatory response.

Correlation study of serum Lp-PLA2 and NSE levels with nerve injury degree and lipid metabolism change in patients with acute cerebral infarction

Objective:To study the correlation of serum Lp-PLA2 and NSE levels with nerve injury degree and lipid metabolism change in patients with acute cerebral infarction.Methods: Patients diagnosed with acute cerebral infarction in our hospital between March 2014 and October 2016 were selected as the cerebral infarction group of the study, and healthy subjects receiving physical examination during the same period were selected as control group. Serum was collected to determine the levels of Lp-PLA2 and NSE as well as the content of nerve injury molecules and lipid metabolism molecules.Results:Serum Lp-PLA2, NSE, NO, MDA, LPO, 8-OHdG, ox-LDL, LDL-C and ApoB levels of cerebral infarction group were significantly higher than those of control group while HDL-C and ApoA1 content were significantly lower than those of control group;serum NO, MDA, LPO and 8-OHdG content of patients with NSE>Q3 were significantly higher than those of patients with<Q1, Q1-Q2 and Q2-Q3, serum NO, MDA, LPO and 8-OHdG content of patients with Q2-Q3 were significantly higher than those of patients with<Q1 and Q1-Q2, and serum NO, MDA, LPO and 8-OHdG content of patients with Q1-Q2 were significantly higher than those of patients with<Q1;serum ox-LDL, LDL-C and ApoB content of patients with Lp-PLA2>Q3 were significantly higher than those of patients with<Q1, Q1-Q2 and Q2-Q3 while HDL-C and ApoA1 content were significantly lower than those of patients with<Q1, Q1-Q2 and Q2-Q3;serum ox-LDL, LDL-C and ApoB content of patients with Q2-Q3 were significantly higher than those of patients with <Q1 and Q1-Q2 while HDL-C and ApoA1 content were significantly lower than those of patients with<Q1 and Q1-Q2;serum ox-LDL, LDL-C and ApoB content of patients with Q1-Q2 were significantly higher than those of patients with<Q1 while HDL-C and ApoA1 content were significantly lower than those of patients with<Q1.Conclusion: Serum Lp-PLA2 and NSE levels increase significantly in patients with acute cerebral infarction, the increase of Lp-PLA2 is associated with abnormal lipid metabolism, and the increase of NSE is associated with neural oxidative damage.

Hyperbaric oxygen preconditioning induces neuroprotection against ischemia in transient not permanent middle cerebral artery occlusion rat model

This study was designed to determine if repeated hyperbaric oxygen (HBO) exposure induces ischemic tolerance in focal cerebral ischemia Methods Sixty male SD rats were used in this study Thirty animals underwent transient middle cerebral artery occlusion (MCAO) and the other thirty permanent MCAO model The rats were randomly allocated to 3 sub-groups: control group (n=10), HBO-3 group (n=10), and HBO-5 group (n=10) The animals in HBO-3 and HBO-5 groups received 1*!hour hyperbaric oxygenation at 2 5 atmosphere absolute (ATA) in 100% oxygen every day for 3 and 5 days, respectively The animals in the control group received sham treatments 24*!hours after the last HBO, transient MCAO (120 min) and permanent MCAO were induced by introducing a 3-0 nylon monofilament suture through internal carotid artery based on the Koizumi technique The neurological outcome was evaluated until 24*!hours after reperfusion in transient MCAO rats and ischemia in permanent MCAO rats The infarct volume was then assessed by TTC staining Results In transient MCAO rats, the neurological outcome in both the HBO-3 and HBO-5 groups was better than that of the control group ( P <0 05 and 0 001) The infarct volume decreased from 171 5±113*!mm 3 to 40 6±49 9*!mm 3 ( P <0 05) in the HBO-3 group and 16 2±28 8*!mm 3 ( P <0 01) in the HBO-5 group There were no significant differences in neurological outcome and infarct volume among the three groups in permanent MCAO rats Conclusions The present study demonstrated that HBO preconditioning can induce ischemic tolerance in transient not permanent MCAO rats in a “dose-dependent' manner

不同时间窗高压氧治疗对急性脑梗死患者颈动脉血流动力学及血清Hcy、sICAM-1、IL-1β水平的影响

目的 探讨不同治疗时间窗高压氧治疗对急性脑梗死(ACI)患者颈动脉血流动力学及血清同型半胱氨酸(Hcy)、可溶性细胞间黏附分子-1 (sICAM-1)、白细胞介素-1β (IL-1β)水平的影响。方法 选取2022年10月至2023年12月昆明医科大学第一附属医院神经内科收治的180例ACI患者,根据随机数字表法分为4组,各45例。对照组不接受高压氧治疗,早期组在发病72h内接受高压氧治疗,中期组在发病3~7d内接受高压氧治疗,晚期组在发病7d后接受高压氧治疗。对比各组临床疗效、颈动脉血流动力学状况及血清Hcy、sICAM-1、IL-1 β水平变化。结果 治疗后,早期组总有效率显著高于中期组、晚期组及对照组(^(均)P<0.05)。治疗后,早期组美国国立卫生院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分均低于中期组、晚期组及对照组,中期组低于晚期组及对照组(^(均)P<0.05);早期组治疗后颈动脉平均血流速(Vm)、搏动指数(PI)、阻力指数(RI)优于中期组、晚期组和对照组,中期组颈动脉Vm、PI、RI又优于晚期组和对照组(^(均)P<0.05);早期组治疗后血清Hcy、sICAM-1及IL-1 β水平低于中期组、晚期组和对照组,中期组血清Hey、sICAM-1及IL-1 β水平又低于晚期组和对照组(^(均)P <0.05)。结论 ACI患者在发病72 h内接受高压氧治疗效果显著,可有效改善颈动脉血流状况,降低血管损害和炎症反应程度,具有较高安全性。

“智三针”联合高压氧对脑梗死后血管性认知障碍患者认知功能及日常生活活动能力的影响

目的探讨“智三针”联合高压氧治疗脑梗死后血管性认知障碍(VCI)的临床效果。方法选取2021年5月至2023年5月萍乡市人民医院收治的90例脑梗死后VCI患者作为研究对象,按随机数字表法将其分为三组,每组各30例。三组均予以常规脑梗死治疗,对照1组予以“智三针”治疗,对照2组予以高压氧治疗,观察组予以“智三针”联合高压氧治疗,持续3个疗程。比较三组的临床疗效、认知功能、日常生活活动能力。结果观察组患者的总有效率高于对照1组、对照2组,差异有统计学意义(P<0.017);观察组患者治疗后的简易精神量表(MMSE)评分、蒙特利尔认知功能量表(MoCA)评分[(28.41±1.23)、(28.74±1.32)分]高于对照2组[(24.36±1.58)、(25.02±1.29)分]和对照1组[(24.42±1.63)、(25.08±1.31)分],差异有统计学意义(P<0.05)。观察组患者治疗后的Barthel指数(BI)评分[(60.58±5.36)分]高于对照2组[(50.41±5.22)分]和对照1组[(50.57±5.25)分],差异有统计学意义(P<0.05)。结论“智三针”联合高压氧可提高脑梗死后VCI治疗效果,加快患者认知功能恢复,减轻氧化应激损伤及血管内皮障碍,改善日常生活活动能力。

高压氧联合丁苯酞治疗脑梗死患者的效果

目的:探讨高压氧联合丁苯酞治疗脑梗死患者的效果。方法:选取2020年1月—2022年12月莆田学院附属医院收治的90例脑梗死患者作为研究对象,按照随机抽签法将患者分为观察组与对照组,各45例。两组均给予常规治疗,其中对照组加用丁苯酞,观察组在对照组基础上联用高压氧,比较两组临床疗效、神经功能缺损情况、脑血流动力学、生活质量。结果:观察组治疗总有效率为97.78%,高于对照组的84.44%,差异有统计学意义(P<0.05);观察组治疗10 d、20 d美国国立卫生研究院脑卒中量表(NIHSS)评分低于对照组,差异有统计学意义(P<0.05);治疗后,两组脑平均血流速度及生理、心理、社会、环境评分高于治疗前,且观察组治疗后更高,两组治疗后血细胞比容、纤维蛋白原低于治疗前,且观察组治疗后更低,差异有统计学意义(P<0.05)。结论:高压氧联合丁苯酞治疗脑梗死效果佳,能改善神经功能缺损程度和脑血流动力学,提高生活质量。

多导睡眠监测仪分析不同阶段高压氧对急性脑梗死后睡眠障碍的治疗效果

目的多导睡眠监测仪分析不同阶段高压氧对急性脑梗死后睡眠障碍的治疗效果。方法选取急性脑梗死后睡眠障碍患者120例随机均分为观察组以及对照组,均予以口服氟哌噻吨美利曲辛片常规治疗,观察组于发病0~7 d、对照组于发病8~14 d给予高压氧治疗;分别于治疗前、治疗4周时使用多导睡眠监测仪监测两组总睡眠时间(TST)、睡眠效率(SE)、第一阶段睡眠(TS1)、第二阶段睡眠(TS2)、第三阶段睡眠(TS3)、第四阶段睡眠(TS4)睡眠、快速眼动睡眠时间(REM)、觉醒期时间(WASO)、睡眠潜伏期时间(SL)及觉醒次数,评估患者睡眠状况与治疗效果;采集患者空腹静脉血检测胆碱酶活性,采用汉密尔顿抑郁量表(HAMD)评估患者负面情绪,并记录患者不良睡眠事件。结果治疗后,两组患者TST、SE、TS1、TS2、TS3、TS4、REM、WASO及SL均显著改善,且观察组均优于对照组(P<0.05);治疗4周后,两组患者的觉醒次数均较治疗前改善,且观察组患者觉醒次数低于对照组,差异有统计学意义(P<0.05);治疗后,观察组患者血液胆碱酶活性显著低于对照组(t=30.233,P<0.001);治疗后,两组患者的HAMD评分均降低,且观察组低于对照组(P<0.05);治疗后,观察组患者发生睡眠期周期性肢体运动、快动眼睡眠行为异常低于对照组(P<0.05)。结论早期给予急性脑梗死后睡眠障碍患者高压氧治疗的效果好,采用多导睡眠监测仪可监测高压氧的治疗效果。

曲克芦丁脑蛋白水解物联合高压氧治疗脑梗死的临床疗效及对患者血浆同型半胱氨酸和脂联素与血小板溶酶体膜蛋白的影响

目的探讨曲克芦丁脑蛋白水解物联合高压氧治疗脑梗死的临床疗效及对患者血浆同型半胱氨酸(Hcy)、脂联素(APN)、血小板溶酶体膜蛋白(CD62P)水平的影响。方法选取2020年1月至2022年1月栖霞市人民医院收治的90例脑梗死患者作为研究对象,按照随机信封法分为观察组与对照组,每组45例。对照组采用高压氧治疗,观察组采用曲克芦丁脑蛋白水解物联合高压氧治疗,比较两组临床疗效、血液流变学指标、Hcy、APN、CD62P水平。结果观察组治疗总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05)。治疗1个月后,两组血浆黏度、全血黏度高切、全血黏度低切均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗1个月后,两组Hcy、CD62P水平均低于治疗前,APN水平高于治疗前,且观察组Hcy、CD62P水平均低于对照组,APN水平高于对照组,差异有统计学意义(P<0.05)。结论曲克芦丁脑蛋白水解物联合高压氧治疗脑梗死的效果显著,可改善患者血液流变学指标,减轻脑组织损伤。

早期多频次高压氧治疗急性脑梗死患者的效果

目的:观察早期多频次高压氧治疗急性脑梗死患者的效果。方法:回顾性分析2022年7月至2023年7月该院收治的90例急性脑梗死患者的临床资料,依据高压氧治疗频次不同将其分为对照组和研究组各45例。对照组应用低频次高压氧治疗,研究组应用多频次高压氧治疗,比较两组疗效,治疗前后神经功能缺损[美国国立卫生研究院卒中量表(NIHSS)]评分、日常生活能力[改良Barthel指数(MBI)]评分、神经功能指标[神经元特异性烯醇化酶(NSE)、中枢神经特异性蛋白(S100β)、胶质纤维酸性蛋白(GFAP)]水平、炎性因子[C反应蛋白(CRP)、基质金属蛋白酶-9(MMP-9)]水平,以及不良反应发生率。结果:研究组治疗总有效率为95.56%(43/45),高于对照组的82.22%(37/45),差异有统计学意义(P<0.05);治疗后,研究组NIHSS评分低于对照组,MBI评分高于对照组,差异均有统计学意义(P<0.05);治疗后,研究组S100β、NSE、GFAP、CRP、MMP-9水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:早期多频次高压氧治疗急性脑梗死患者可提高治疗总有效率和日常生活能力评分,降低NIHSS评分、神经功能指标水平和炎性因子水平,效果优于低频次高压氧治疗。

支持-表达性团体干预在脑梗死恢复期高压氧治疗病人中的应用

目的:探究支持-表达性团体干预对脑梗死恢复期高压氧治疗病人恐惧疾病进展与自我感受负担的影响。方法:采取便利抽样法选取2022年1月—2023年4月在我院接受高压氧治疗的110例脑梗死恢复期病人为研究对象,为避免科室内沾染,将2022年1月—8月收治的55例病人列为对照组,实施常规护理,2022年9月—2023年4月收治的55例病人列为研究组,在对照组基础上实施支持-表达性团体干预。比较两组病人干预前后恐惧疾病进展与自我感受负担水平。结果:干预4周后,研究组病人恐惧疾病进展量表和自我感受负担量表的总分及各维度得分均低于对照组,差异有统计学意义(P<0.05)。结论:支持-表达性团体干预能够降低脑梗死恢复期高压氧治疗病人对疾病进展的恐惧程度,减轻其自我感受负担水平。

高压氧联合丁苯酞对老年脑梗死后血管性痴呆患者神经功能及认知功能的影响

目的探讨高压氧联合丁苯酞对老年脑梗死后血管性痴呆患者神经功能及认知功能的影响。方法选择该院2020年3月—2023年3月收治的82例老年脑梗死后血管性痴呆患者为研究对象,按随机数字表法将其分为对照组与观察组,各41例。对照组采用丁苯酞治疗,观察组采用高压氧联合丁苯酞治疗。比较两组患者的神经功能、认知功能、记忆能力、不良反应发生情况。结果治疗后,观察组美国国立卫生研究院卒中量表评分低于对照组,简易精神状态检查量表评分高于对照组,组间差异有统计学意义(P<0.05)。观察组临床记忆量表的各个维度评分均高于对照组,组间差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论高压氧联合丁苯酞可改善老年脑梗死后血管性痴呆患者神经功能及认知功能,增强其记忆力,安全性较好。

急性脑梗死病人的不同疗程高压氧治疗作用及对神经功能的影响

目的 探讨急性脑梗死病人的不同疗程高压氧治疗作用及对神经功能的影响。方法 选取2021年3月—2023年3月本院收治的80例急性脑梗死患者进行观察,应用随机数字表法分为对照组和实验组,每组40例。其中,对照组行常规治疗,实验组在对照组基础上加以高压氧治疗,治疗后比较两组临床效果。结果 实验组神经功能及日常生活活动能力改善情况均优于对照组(P<0.05),治疗总有效率高于对照组(P<0.05)。结论 高压氧治疗急性脑梗死的效果显著,随着疗程增加,患者神经功能及自理能力不断改善,依据患者病情予以不同疗程的治疗方案具有积极意义。

高压氧治疗前后脑梗死患者血清一氧化氮及氧自由基的变化与疗效评价

目的评价高压氧治疗脑梗死的效果,并探讨脑梗死患者高压氧治疗前后血清一氧化氮(NO)及超氧化物歧化酶(SOD)、丙二醛(MDA)含量的变化及这些指标的应用价值。方法将60例脑梗死患者,随机(抛币法)分为高压氧综合治疗组和药物对照组,两组均以疗效标准判断疗效,并测定两组患者治疗前后血清NO,SOD,MDA含量,进行比较判定。结果高压氧组有效率为87%,对照组有效率为63%,高压氧组有效率明显高于对照组。治疗后两组患者血清NO含量较治疗前增加,高压氧组NO含量明显高于对照组。本实验中SOD,MDA无明显变化。结论(1)高压氧综合治疗脑梗死效果明显优于单纯药物治疗。(2)血清NO含量可作为脑梗死患者病情变化及高压氧综合疗效判定的参考指标。

高压氧对实验性脑梗死大鼠神经可塑性的影响

目的:探讨高压氧对缺血性脑梗死后神经可塑性的影响及其作用机制。方法:选择4～5个月龄雄性SD大鼠90只,随机分为假手术组、模型组和高压氧组。建立大脑中动脉闭塞模型,在术后3 h对HBO组大鼠开始高压氧治疗。以横木行走试验进行神经功能评分,高压氧治疗后第1,2周采用免疫组织化学技术检测微管相关蛋白-2(microtubule-associated protein-2,MAP-2)和胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)的分布,并用实时荧光定量PCR(real-time quantitative PCR,RT-PCR)检测梗死灶周Map-2 mRNA及GFAP mRNA表达量的变化。结果:脑梗死后第2周,大鼠平衡木试验显示高压氧组大鼠肢体功能评分较模型组低。免疫组织化学及荧光定量PCR结果均显示:高压氧治疗第1周,高压氧组梗死灶周围Map-2及Map-2 mRNA表达较假手术组及模型组显著增加,GFAP及GFAP mRNA表达较模型组明显减少但仍比假手术组高;高压氧治疗第2周,高压氧组梗死灶周围Map-2及Map-2 mRNA表达仍较假手术组及模型组高,GFAP及GFAP mRNA表达仍较模型组明显减少但比假手术组高。结论:缺血性脑梗死后,早期反复高压氧治疗可有效地改善肢体运动功能,并可通过促进Map-2以及抑制GFAP的表达促进缺血性脑梗死后神经的可塑性。

大剂量高压氧对脑梗死大鼠细胞色素C及caspase-3的影响

目的观察单次高压氧(HBO)治疗9 h对永久性大脑中动脉阻塞(MCAO)大鼠细胞色素C和caspase-3水平的影响。方法48只Sprague-Dawley大鼠制作永久性MCAO模型,分为对照组(n=24)和高压氧组(n=24),高压氧组大鼠于造模成功后3 h予单次高压氧治疗9 h,压力0.2 MPa。于造模成功后3 h、13 h、24 h行大鼠Garcia神经功能评分,于造模成功后13 h、24 h TUNEL法检测大鼠脑组织细胞凋亡数,ELISA法检测缺血半暗带脑组织细胞色素C及活性caspase-3水平。结果两组大鼠造模成功后13h、24 h神经功能均有明显改善,两组间无显著性差异(t<2.07,P>0.05)。两组造模成功后13 h、24 h均见凋亡细胞,高压氧组明显少于对照组(t>6.57,P<0.01)。高压氧组细胞色素C和caspase-3的水平在造模成功后24 h低于对照组(t>2.41,P<0.05)。结论大剂量高压氧超早期治疗可降低脑缺血后细胞色素C和caspase-3水平,减少细胞凋亡,可能是高压氧治疗脑梗死的机制之一。