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中华脑科疾病与康复杂志(电子版) ›› 2023, Vol. 13 ›› Issue (02) : 97 -101. doi: 10.3877/cma.j.issn.2095-123X.2023.02.005

临床研究

早期高压氧治疗外伤性脑梗死的临床疗效及安全性分析
祝梅杰, 梁育磊, 梅厚东, 刘克万, 武孝刚†()   
  1. 230031　合肥，解放军联勤保障部队第九〇一医院康复科
    230031　合肥，解放军联勤保障部队第九〇一医院神经外科
  • 收稿日期:2022-09-30 出版日期:2023-04-15
  • 通信作者: 武孝刚

Clinical observation of early hyperbaric oxygen in the treatment of traumatic cerebral infarction

Meijie Zhu, Yulei Liang, Houdong Mei, Kewan Liu, Xiaogang Wu†()   

  1. Department of Rehabilitation, The 901st Hospital of the Joint Logistics Support Force of PLA, Hefei 230031, China
    Department of Neurosurgery, The 901st Hospital of the Joint Logistics Support Force of PLA, Hefei 230031, China
  • Received:2022-09-30 Published:2023-04-15
  • Corresponding author: Xiaogang Wu
  • Supported by:
    2020 Wannan Medical College Teaching Hospital Scientific Research Special Project(JXYY202018)
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祝梅杰, 梁育磊, 梅厚东, 刘克万, 武孝刚. 早期高压氧治疗外伤性脑梗死的临床疗效及安全性分析[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(02): 97-101.

Meijie Zhu, Yulei Liang, Houdong Mei, Kewan Liu, Xiaogang Wu. Clinical observation of early hyperbaric oxygen in the treatment of traumatic cerebral infarction[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2023, 13(02): 97-101.

目的

观察早期行高压氧治疗外伤性脑梗死的临床疗效，分析其治疗的安全性。

方法

回顾性分析解放军联勤保障部队第九〇一医院神经外科自2018年1月至2021年1月收治的68例颅脑损伤合并脑梗死患者的临床资料。根据治疗方式将患者分为2组，其中对照组患者（32例）收治住院后给予常规药物治疗，必要时需行手术治疗；治疗组患者（36例）在对照组患者治疗的基础上，待病情稳定后早期行高压氧治疗，10 d为1个疗程。采用Fugl-Meyer上下肢功能量表（FMA）和神经功能缺损量表（NDS）评价患者治疗前及治疗后60 d的四肢运动功能及神经缺损程度；治疗后180 d，采用改良的Rankin量表（mRS）分级法评定2组患者的远期疗效，并做Kaplan-Meier分析。

结果

与本组治疗前比较，2组患者治疗后60 d的FMA评分升高，NDS评分降低，且治疗组FMA评分高于对照组，NDS评分低于对照组，差异均具有统计学意义（P<0.05）。治疗组患者治疗后180 d的mRS评分明显优于对照组，且Kaplan-Meier曲线明显高于对照组患者，差异具有统计学意义（P<0.05）。2组患者均无严重不良反应发生。

结论

早期高压氧治疗能够提高外伤性脑梗死患者的临床治疗效果，降低死亡率，且无严重不良反应发生。

关键词: 外伤性脑梗死, 高压氧, 运动功能, 神经缺损, 远期疗效
Objective

To observe the clinical effect of early hyperbaric oxygen on traumatic cerebral infarction and analyze its safety.

Methods

From January 2018 to January 2021, a total of 68 patients with combined cerebral infarction and craniocerebral injury were treated in the Neurosurgery Department of the 901st Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army. According to the treatment method, the patients were divided into two groups. Among them, the control group (32 cases) received routine drug therapy and surgical treatment if necessary after hospitalization, while the treatment group (36 cases) received hyperbaric oxygen therapy after stabilization on the basis of the control group. A course of treatment lasted 10 d. The Fugl-Meyer Assessment (FMA) and the Neurological Deficit Scale (NDS) were used to evaluate the four-limb motor function and neurological deficit degree of patients before and 60 d after treatment. After 180 d of treatment, the modified Rankin scale (mRS) was used to assess the long-term efficacy, and Kaplan-Meier analysis was performed on the two groups of patients.

Results

The FMA score of the two groups at 60 d after treatment was higher than that before treatment, while the NDS score at 60 d after treatment was lower than that before treatment (P<0.05); The FMA score of the treatment group at 60 d after treatment was higher than that of the control group, and the NDS score was lower than that of the control group (P<0.05). After 180 d of treatment, the mRS score of the treatment group was significantly better than that of the control group, and the Kaplan-Meier curve of the treatment group patients was significantly higher than that of the control group patients, with a statistically significant difference (P<0.05). No serious adverse reactions occurred in 2 groups.

Conclusion

Early hyperbaric oxygen therapy can improve the clinical efficacy of traumatic cerebral infarction patients, reduce their mortality, and no serious adverse reactions, worthy of clinical use.

Key words: Traumatic cerebral infarction, Hyperbaric oxygen, Motor function, Neurological deficit, Long-term efficacy
表1 2组患者一般资料比较
Tab.1 Comparison of general information between the two groups
组别 例数 性别[例（%）] 年龄（岁，Mean±SD） 梗死位置[例（%）] GCS评分（分，Mean±SD）
男 女 大脑 小脑 脑干 多发梗死 ≤5 6~9 ≥10
对照组 32 19（59.38） 13（40.62） 54.3±6.8 20（62.50） 3（9.38） 3（9.38） 6（18.74） 5（15.63） 14（43.75） 13（40.62）
治疗组 36 22（61.11） 14（38.89） 52.4±8.5 24（66.67） 3（8.33） 1（2.78） 8（22.22） 6（16.67） 18（50.00） 12（33.33）
t/χ2值   0.210 0.170 1.419 0.397
P值   0.884 0.986 0.701 0.820
表2 2组患者治疗前后FMA、NDS评分比较（分，Mean±SD）
Tab.2 Comparison of FMA and NDS scores before and after treatment between the two groups (score, Mean±SD)
组别 例数 FMA评分 NDS评分
治疗前 治疗后60 d t值 P值 治疗前 治疗后60 d t值 P值
对照组 32 31.97±7.78 48.23±3.37 -9.716 <0.001 32.09±4.47 21.86±3.13 7.213 <0.001
治疗组 36 33.86±9.91 61.42±4.68 -12.298 <0.001 33.46±8.92 12.35±2.81 14.975 <0.001
t值   -0.206 -15.603     -0.398 13.578    
P值   0.838 <0.001     0.692 <0.001    
图1 2组患者治疗后180 d mRS评分对比
Fig1. Comparison of mRS scores at 180 d after treatment between the two groups
图2 2组患者治疗后180 d Kaplan-Meier生存曲线分析对比
Fig2. Comparison of Kaplan-Meier survival curves at 180 d after treatment between the two groups
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