中华航海医学与高气压医学杂志
中華航海醫學與高氣壓醫學雜誌
중화항해의학여고기압의학잡지
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
2015年
4期
271-275
,共5页
王磊%谭莹%朱昱亭%朱子煜%董豪%李厚成%李彬彬
王磊%譚瑩%硃昱亭%硃子煜%董豪%李厚成%李彬彬
왕뢰%담형%주욱정%주자욱%동호%리후성%리빈빈
高压氧%脑循环电刺激治疗%缺血性脑卒中
高壓氧%腦循環電刺激治療%缺血性腦卒中
고압양%뇌순배전자격치료%결혈성뇌졸중
Hyperbaric oxygen%Cerebral circular electro-stimulation treatment%Ischemic stroke
目的 探讨高压氧联合脑循环电刺激治疗对缺血性脑卒中患者的临床疗效.方法 将152例缺血性脑卒中患者按照治疗方法分为4组,其中联合治疗组38例,脑循环治疗组38例,高压氧组38例,常规药物治疗38例(对照组).应用经颅多普勒超声技术和脑电图分别检测刺激前后的大脑前、中、后动脉及椎动脉、基底动脉的血流速度及各频段脑电波(α、β、δ、θ波)的变化;用美国国立卫生研究院卒中量表(NIHSS)评分及Bathel指数作为疗效标准依据进行疗效对比.结果 脑循环治疗组、高压氧组患者脑血流速度较对照组显著增高,联合治疗组大脑中、前动脉、椎动脉、基底动脉平均流速分别由治疗前的(35.13 ±3.47)、(34.28 ±4.25)、(21.45 ±3.23)、(20.47±3.58) cm/s增至治疗后的(60.23 ±4.32)、(57.48 +5.23)、(36.84±2.75)、(35.47 ±3.17)cm/s,差异均有统计学意义(p＜0.05),联合治疗组脑电图α波由治疗前(56.25±3.86) μV2增加至(90.47±4.35) μV2,θ、δ波分别由(22.23±2.63) μV2、(19.24 ±3.57) μV2降至(10.37±2.31) μY2、(8.19±3.28) μV2,差异有统计学意义(P＜0.05);NIHSS评分在各组治疗后均降低,联合治疗组由治疗前(22.89 ±8.15)分降至(14.53±6.54)分,差异有统计学意义(P＜0.05),脑循环组及高压氧治疗组在治疗后有效率达76.3％和73.4％,与对照组57.9％比较差异有统计学意义(P＜0.05),而联合治疗组为86.8％,组间差异有统计学意义(P＜0.05).联合治疗组Bathel指数由治疗前(28.73 ±6.89)增至(68.28 ±8.17),与治疗前及各组间治疗后比较差异有统计学意义(P＜0.05).结论 高压氧、脑循电刺激治疗均可提高缺血性脑卒中患者的脑血流量,改善脑细胞功能,促使缺血性脑卒中患者早期恢复,二者合用疗效更显著.
目的 探討高壓氧聯閤腦循環電刺激治療對缺血性腦卒中患者的臨床療效.方法 將152例缺血性腦卒中患者按照治療方法分為4組,其中聯閤治療組38例,腦循環治療組38例,高壓氧組38例,常規藥物治療38例(對照組).應用經顱多普勒超聲技術和腦電圖分彆檢測刺激前後的大腦前、中、後動脈及椎動脈、基底動脈的血流速度及各頻段腦電波(α、β、δ、θ波)的變化;用美國國立衛生研究院卒中量錶(NIHSS)評分及Bathel指數作為療效標準依據進行療效對比.結果 腦循環治療組、高壓氧組患者腦血流速度較對照組顯著增高,聯閤治療組大腦中、前動脈、椎動脈、基底動脈平均流速分彆由治療前的(35.13 ±3.47)、(34.28 ±4.25)、(21.45 ±3.23)、(20.47±3.58) cm/s增至治療後的(60.23 ±4.32)、(57.48 +5.23)、(36.84±2.75)、(35.47 ±3.17)cm/s,差異均有統計學意義(p＜0.05),聯閤治療組腦電圖α波由治療前(56.25±3.86) μV2增加至(90.47±4.35) μV2,θ、δ波分彆由(22.23±2.63) μV2、(19.24 ±3.57) μV2降至(10.37±2.31) μY2、(8.19±3.28) μV2,差異有統計學意義(P＜0.05);NIHSS評分在各組治療後均降低,聯閤治療組由治療前(22.89 ±8.15)分降至(14.53±6.54)分,差異有統計學意義(P＜0.05),腦循環組及高壓氧治療組在治療後有效率達76.3％和73.4％,與對照組57.9％比較差異有統計學意義(P＜0.05),而聯閤治療組為86.8％,組間差異有統計學意義(P＜0.05).聯閤治療組Bathel指數由治療前(28.73 ±6.89)增至(68.28 ±8.17),與治療前及各組間治療後比較差異有統計學意義(P＜0.05).結論 高壓氧、腦循電刺激治療均可提高缺血性腦卒中患者的腦血流量,改善腦細胞功能,促使缺血性腦卒中患者早期恢複,二者閤用療效更顯著.
목적 탐토고압양연합뇌순배전자격치료대결혈성뇌졸중환자적림상료효.방법 장152례결혈성뇌졸중환자안조치료방법분위4조,기중연합치료조38례,뇌순배치료조38례,고압양조38례,상규약물치료38례(대조조).응용경로다보륵초성기술화뇌전도분별검측자격전후적대뇌전、중、후동맥급추동맥、기저동맥적혈류속도급각빈단뇌전파(α、β、δ、θ파)적변화;용미국국립위생연구원졸중량표(NIHSS)평분급Bathel지수작위료효표준의거진행료효대비.결과 뇌순배치료조、고압양조환자뇌혈류속도교대조조현저증고,연합치료조대뇌중、전동맥、추동맥、기저동맥평균류속분별유치료전적(35.13 ±3.47)、(34.28 ±4.25)、(21.45 ±3.23)、(20.47±3.58) cm/s증지치료후적(60.23 ±4.32)、(57.48 +5.23)、(36.84±2.75)、(35.47 ±3.17)cm/s,차이균유통계학의의(p＜0.05),연합치료조뇌전도α파유치료전(56.25±3.86) μV2증가지(90.47±4.35) μV2,θ、δ파분별유(22.23±2.63) μV2、(19.24 ±3.57) μV2강지(10.37±2.31) μY2、(8.19±3.28) μV2,차이유통계학의의(P＜0.05);NIHSS평분재각조치료후균강저,연합치료조유치료전(22.89 ±8.15)분강지(14.53±6.54)분,차이유통계학의의(P＜0.05),뇌순배조급고압양치료조재치료후유효솔체76.3％화73.4％,여대조조57.9％비교차이유통계학의의(P＜0.05),이연합치료조위86.8％,조간차이유통계학의의(P＜0.05).연합치료조Bathel지수유치료전(28.73 ±6.89)증지(68.28 ±8.17),여치료전급각조간치료후비교차이유통계학의의(P＜0.05).결론 고압양、뇌순전자격치료균가제고결혈성뇌졸중환자적뇌혈류량,개선뇌세포공능,촉사결혈성뇌졸중환자조기회복,이자합용료효경현저.
Objective To investigate the clinical effects of hyperbaric oxygen (HBO) combined cerebral circular electro-stimulation in the treatment of patients with ischemic stroke.Methods One hundred and fifty-two patients with ischemic stroke were divided by different treatment methods into 4 groups:the combined treatment group,the cerebral circular electro-stimulation group,the HBO group and the drug routine group (the control group),each consisting of 38 patients.Blood flow rates of anterior cerebral artery (ACA),middle cerebral artery (MCA),posterior cerebral artery (PCA),vertebral artery (VA) and basilar artery (BA),and changes in cerebral wave lengths (α,β,δ and θ waves) both before and after stimulation were respectively detected with transcranial Doppler (TCD) and EEG.The National Institute of Health Stroke Scale (NIHSS) and the Bathel Index were used as standards for comparisons of therapeutic effects between groups.Results Cerebral blood flow rates for the patients in the cerebral circular electro-stimulation group and the HBO group were all increased,as compared with that of the control group.For the patients in the combined treatment group,average blood flow rates of MCA (35.13 ±3.47)cm/s,ACA(34.28 ± 4.25)cm/s,VA (21.45 ± 3.23) cm/s and BA (20.47 ± 3.58) cm/s before treatment were respectively increased to the levels of (60.23 ± 4.32) cm/s,(57.48 + 5.23) cm/s,(36.84 ± 2.75) cm/s and (35.47 ± 3.17) cm/s after treatment,with statistical significance(P ＜ 0.05).Statistical significance could be noted,when comparisons were made after treatment between the combined treatment group and the cerebral circular electro-stimulation and the HBO groups(P ＜ 0.05).For the patients in the combined treatment group,EEG o wave length was increased from (56.25 ± 3.86)μV2 before treatment to(90.47 ±4.35)μV2 after treatment,while the wave lengths of θ wave and δ wave lengths were decreased from (22.23 ± 2.63) μV2 and (19.24 ± 3.57) μV2 before treatment to (10.37 ± 2.31) μV2 and 8.19 ± 3.28) μV2 after treatment,with statistical significance (P ＜ 0.05).After treatment,the scores of NIHSS for all the groups were decreased dramatically.The NIHSS scores for the combined treatment group were decreased from 22.89 ± 8.15) before treatment to (14.53 ± 6.54) after treatment,with statistical significance (P ＜ 0.05).Statistical significance could also be noticed,when they were compared with those of the cerebral circular electro-stimulation and the HBO groups (P ＜ 0.05).The therapeutic efficacy achieved following treatment for the cerebral circular electro-stimulation and the HBO groups was respectively 76.3％ and 73.4％,and there was statistical significance,when compared with that of the control group(P ＜ 0.05),while the therapeutic efficacy for the combined treatment group was 86.8％,and statistical significance could also be noted,when comparisons were made between the groups(P ＜ 0.05).The Bathel Index for the combined treatment group was increased from(28.73 ± 6.89)before treatment to(68.28 ± 8.17)after treatment,and statistical significance could be found,when compared with that before treatment and those of other groups after treatment(P ＜ 0.05).Conclusions HBO and cerebral circular electro-stimulation could all increase cerebral blood flow of the patients with ischemic stroke,improve brain cell function and promote early recovery of the patients with ischemic stroke,and combined treatment of HBO and cerebral circular electro-stimulation could achieve much better effects.
