摘要
目的探讨高压氧(HBO)疗法在高血压脑出血(HICH)患者神经内镜血肿清除术后治疗中的应用效果。方法选取2021年1月—2024年1月于扬州大学附属医院接受治疗的HICH患者102例作为研究对象,采用随机数字表法将患者分为常规组与HBO组,各51例。患者入院后均接受神经内镜血肿清除术。术后,常规组患者接受常规治疗,HBO组患者在常规组基础上接受HBO治疗。比较两组治疗前、治疗1个月后脑血流动力学指标[脑血管平均血流速度(Vm)、平均血流量(Qm)、外周血流阻力(R)、动态阻力(DR)]、血清学指标[基质金属蛋白酶9(MMP-9)、细胞间黏附分子1(ICAM-1)、神经元特异性烯醇化酶(NSE)、超敏C反应蛋白(hs-CRP)水平]、相关量表评分[美国国立卫生研究院卒中量表(NIHSS)、简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、Fugl-Meyer运动功能评估量表(FMA)、日常生活活动能力(ADL)量表评分],短期预后[采用格拉斯哥预后量表(GOS)评估]。结果治疗后,HBO组脑血管Vm快于常规组,脑血管Qm大于常规组,脑血管R、DR小于常规组(P<0.05)。治疗后,HBO组血清MMP-9、ICAM-1、NSE、hs-CRP水平低于常规组(P<0.05)。治疗后,HBO组NIHSS评分低于常规组,MMSE、MoCA、FMA、ADL量表评分高于常规组(P<0.05)。随访3个月,HBO组短期预后优于常规组(Z=3.011,P=0.003)。结论HBO疗法可有效改善HICH患者神经内镜血肿清除术后的脑血流动力学,减轻神经功能损伤及炎症反应,改善认知功能,提高运动功能及ADL,进而改善预后。
Objective To discuss the application effect of hyperbaric oxygen(HBO)therapy in postoperative treatment of patients with hypertensive intracerebral hemorrhage(HICH)after neuroendoscopic hematoma evacuation.Methods A total of 102 HICH patients treated in the Affiliated Hospital of Yangzhou University from January 2021 to January 2024 were selected as the research subjects.They were divided into the conventional group and the HBO group using the random number table method,with 51 patients in each group.After admission,all patients underwent neuroendoscopic hematoma evacuation.After operation,patients in the conventional group received conventional treatment,while patients in the HBO group received HBO therapy on the basis of conventional treatment.The cerebral hemodynamic indicators[cerebral mean velocity(Vm),mean blood flow(Qm),peripheral vascular resistance(R),dynamic resistance(DR)],serological markers[matrix metalloproteinase-9(MMP-9),intercellular adhesion molecules-1(ICAM-1),neuron-specific enolase(NSE),high sensitivity C-reactive protein(hs-CRP)],related scales scores[National Institutes of Health Stroke Scale(NIHSS),Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment Scale(MoCA),Fugl-Meyer Motor Assessment(FMA),Activities of Daily Living(ADL)Scale scores]before treatment and after 1 month of treatment,and short-term prognosis[evaluated by Glasgow Outcome Scale(GOS)]were compared between the two groups.Results After treatment,cerebral Vm in the HBO group was faster than that in the conventional group,cerebral Qm was larger than that in the conventional group,cerebral R,DR were less than those in the conventional group(P<0.05).After treatment,serum MMP-9,ICAM-1,NSE,hs-CRP levels in the HBO group were lower than those in the conventional group(P<0.05).After treatment,NIHSS score in the HBO group was lower than that in the conventional group,MMSE,MoCA,FMA,ADL Scale scores were higher than those in the conventional group(P<0.05).Follow-up for 3 months,short-term prognosis in the HBO group was better than that in the conventional group(Z=3.011,P=0.003).Conclusion HBO therapy can effectively improve the cerebral vascular hemodynamics of HICH patients after neuroendoscopic hematoma evacuation,alleviate neurological functional impairment and inflammatory responses,improve cognitive function,promote motor function and ADL,thereby improving the prognosis.
作者
吴臣义
姜海啸
朱劲龙
吴银艳
WU Chenyi;JIANG Haixiao;ZHU Jinlong;WU Yinyan(Neurosurgery Department,Affiliated Hospital of Yangzhou University,Yangzhou 225000,China;Neurology Department,Affiliated Hospital of Yangzhou University,Yangzhou 225000,China)
出处
《实用心脑肺血管病杂志》
2025年第11期120-123,129,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
江苏省科技计划青年基金(自然科学)-面上项目(BE2023712)。
关键词
颅内出血
高血压性
神经内镜血肿清除术
高压氧
Intracranial hemorrhage,hypertensive
Neuroendoscopic hematoma evacuation
Hyperbaric oxygen
作者简介
通信作者:吴银艳,E-mail:18083776865@163.com。
