CAJ | 학술논문

目的比较高压氧(hyperbaric oxygen,HBO)治疗与常规疗法治疗急性脑梗死(acute cerebral infarction,ACI)的疗效及探讨HBO治疗的最佳治疗时间窗.方法将2006年6月至2010年12月入住我院的ACI患者196例经知情同意后分为HBO组(98例)和对照组(98例),HBO组再按HBO 治疗时间分为＜6h、6～48 h、＞48 h3个亚组,在常规治疗的基础上加用HBO,HBO治疗采用多人氧舱,在舱内停留120 min,压力0.25 MPa(2.5 ATA),戴面罩吸入纯氧60 min(30 min 2次,中间间歇10min吸舱内空气),加、减压各25 min,1次/d,10d为1个疗程,疗程间隔3～5d,共3个疗程.对照组按照病程亦分为＜6h、6～48 h、＞48 h3个亚组.对所有患者分别于治疗前及疗程结束后进行美国国立卫生研究院卒中量表(NIHSS)评分和Barthel指数(BI)评分,并与常规治疗的ACI患者(对照组)进行比较.结果治疗后HBO各亚组的总有效率(97.3％、90.0％、80.7％)显著高于常规治疗各亚组(85.7％、77.1％、57.1％)(均为P＜0.01);HBO组中＜6h亚组的有效率明显高于6～48 h和＞48 h亚组(P＜0.05),各亚组NIHSS评分明显低于常规治疗组,BI评分明显高于常规治疗组各亚组(均为P＜0.01);HBO组中＜6h亚组明显优于6～48 h和＞48 h亚组(P＜0.05).结论 HBO治疗ACI的疗效显著,并且在发病6h内开始治疗为最佳.
목적 비교고압양(hyperbaric oxygen,HBO)치료여상규요법치료급성뇌경사(acute cerebral infarction,ACI)적료효급탐토HBO치료적최가치료시간창.방법 장2006년6월지2010년12월입주아원적ACI환자196례경지정동의후분위HBO조(98례)화대조조(98례),HBO조재안HBO 치료시간분위＜6h、6～48 h、＞48 h3개아조,재상규치료적기출상가용HBO,HBO치료채용다인양창,재창내정류120 min,압력0.25 MPa(2.5 ATA),대면조흡입순양60 min(30 min 2차,중간간헐10min흡창내공기),가、감압각25 min,1차/d,10d위1개료정,료정간격3～5d,공3개료정.대조조안조병정역분위＜6h、6～48 h、＞48 h3개아조.대소유환자분별우치료전급료정결속후진행미국국립위생연구원졸중량표(NIHSS)평분화Barthel지수(BI)평분,병여상규치료적ACI환자(대조조)진행비교.결과 치료후HBO각아조적총유효솔(97.3％、90.0％、80.7％)현저고우상규치료각아조(85.7％、77.1％、57.1％)(균위P＜0.01);HBO조중＜6h아조적유효솔명현고우6～48 h화＞48 h아조(P＜0.05),각아조NIHSS평분명현저우상규치료조,BI평분명현고우상규치료조각아조(균위P＜0.01);HBO조중＜6h아조명현우우6～48 h화＞48 h아조(P＜0.05).결론 HBO치료ACI적료효현저,병차재발병6h내개시치료위최가.
Objective To compare the curative effects of hyperbaric oxygen(HBO) and conventional therapy on acute cerebral infarction (ACI),and to study the best therapeutic time window of HBO therapy on ACI.Methods One hundred and ninety-six patients with ACI admitted into the hospital from June 2006 to December 2010 were divided into the HBO group ( n =98) and the control group ( n =98 ).The HBO group was subdivided into the ＜ 6 h therapy group,the 6-48 h therapy group and the ＞ 48 h therapy group,in accordance with the duration of HBO exposure.In addition to HBO therapy,the HBO group also received conventional therapy.The patients received HBO therapy once a day,10 days as one therapeutic course,totaling 3 courses.The time used for compression and decompression was 60 min.In the chamber,the patients were exposed to a pressure of 0.25 MPa for a duration of 120 min and breathed pure oxygen with masks for 60 min (30 minutes of oxygen breathing,at a time,and a 10 min interval).All the patients were assessed with National Institute of Health Stroke Scale ( NIHSS ) and Barthel Index (BI) both before treatment and after termination of the treatment courses.Then,they were compared with those ACI patients (the control group)receiving conventional therapy.Results After treatment,total effective rates for each HBO therapy sub-group were 97.3％,90.0％ and 80.7％,which were significantly higher than those of the conventional therapy subgroups with effective rates of 85.7％,77.1％ and 57.1％ respectively (P ＜~ 01 ).In the HBO group,the effective rate for the ＜ 6 h sub-group was significantly higher than those of the 6-48 h and the ＞ 48 h subgroups (P ＜ 0.05 ).NIHSS scores in each HBO sub-group were significantly lower than those of the conventional therapy group,and BI cores were significantly higher than those of all the sub-groups in the conventional group (P ＜ 0.01 ).In the HBO group,the score for the ≤6 h sub-group were obviously superior to those of the 6-48 h and the ≥48 h sub-groups ( P ＜ 0.05 ).Conclusions HBO therapy could produce a significant result for the treatment of ACI and the best therapeutic time was within 6 hours after the onset of ACI.