Hyperbaric treatment of patients with carbon monoxide poisoning in the United States.

INTRODUCTION: Hyperbaric oxygen (HBO2) is effective therapy for carbon monoxide (CO) poisoning. In recent years, many hyperbaric physicians in the US have felt that numbers of patients referred for treatment of CO poisoning have decreased. Further, since the 2002 Weaver et al study (5), there has been discussion regarding the best treatment protocol. This study was conducted to determine numbers of patients treated with HBO2 annually over the past decade in the US and whether there is a consensus about the number of treatments per patient. MATERIALS AND METHODS: A survey was mailed to all US facilities listed in the 2001 UHMS Chamber Directory. Two subsequent mailings were sent to survey nonresponders, followed by telephone contacts. RESULTS: Of the 320 facilities listed in the directory, 10 were nonresponders, 26 had closed since publication and 80 do not treat CO poisoning, leaving 204 facilities. From 1992-2002, a total of 16,367 patients were treated with HBO2 for CO poisoning, an average of 1,488 +/- 121 patients/year (mean < or = SD). While the total number of patients treated annually did not decrease during the period studied, the number treated per facility did decline as a result of an increase in number of treating facilities. Only 46 facilities (23%) automatically give more than 1 hyperbaric treatment per CO-poisoned patient. Among those that do, 20 facilities (10%) give 3 treatments per patient. Conversely, 136 (67%) sometimes give more than one treatment and 12 facilities (8%) never retreat. CONCLUSIONS: Approximately 1,500 CO-poisoned patients are treated with HBO2 in the US annually, a number that has remained relatively constant since 1992. The majority of facilities does not routinely give more than one hyperbaric treatment, but will give repetitive treatment in certain situations.     

高压氧和抗血小板聚集剂预防一氧化碳中毒迟发脑病

目的 观察高压氧（HBO）和抗血小板聚集剂综合疗法对一氧化碳中毒（COP）迟发脑病的预防效应。方法 中，重度急性一氧化碳中毒患者共401例，随机分成HBO治疗组（HBO）组204例和HBO＋抗血小板聚集剂治疗组（HBO＋抗Pla组）197例。HBO治疗压力0.2MPa，每日1次，共20次，在患者COP后第15，20，25，30，45，60天判定是否出现迟发脑病。结果 COP患者401例中，HBO组204例，出现迟发脑病23例，占11．27％。HB＋抗Pla组197例，出现迟发脑病7例，占3．55％。两组比较差异有非常显著性（P＜0．01）。结论 HBO和抗血小板聚集剂综合治疗急性COP，使其迟发脑病的发生率较单纯HBO治疗明显降低，取得显著的预防效应。     

Side effects of hyperbaric oxygen therapy in children with cerebral palsy.

BACKGROUND: This article reports the side effects observed in a double-blind placebo-controlled multi-center randomized clinical trial carried out to assess the efficacy and safety of hyperbaric oxygen (HBO2) therapy in children with cerebral palsy. Intention-to-treat analysis did not prove to have a beneficial effect. MATERIAL AND METHODS: 111 children aged 3 to 12 years were included and followed for 8 weeks. They all received 40 compressions of 1 hour (5 days per week). In the treated group (n=57), HBO2 sessions consisted of an exposure to 100% oxygen at 1.75 atmosphere absolute (atm abs) while children in the control group (n=54) received air at 1.3 atm abs. A physician carried out a general health surveillance including an ear examination prior to and immediately following each session. All clinical events occurring during the course of the study were recorded. FINDINGS: Events were classified in 3 categories: Events related to pressure/volume changes, events related to oxygen toxicity, and other events. No events due to oxygen toxicity were noted. Only middle ear barotrauma significantly differed according to the groups (50% in HBO2 session group versus 27.8% in control group). Other events were rare and equivalent in both groups. CONCLUSION: Short-term exposure to HBO2 at medium level pressure (1.75 atm abs) was responsible for a significant increase of middle ear barotrauma compared to children that received very low external pressure (1.3 atm abs).     

高压氧对一氧化碳中毒大鼠海马神经细胞线粒体膜电位与细胞凋亡的影响

目的 观察一氧化碳中毒（COP）后脑损伤时线粒体膜电位及细胞凋亡数量的变化以及高压氧（HBO）对其影响。方法Wistar大鼠共128只,采用配伍组设计,按随机抽样原则将动物分成4组16小组。正常对照组8只;CO组COP后第1,5,10,15,20天各8只;CO＋HP组高气压处理后第1,5,10,15,20天各8只：CO＋HBO组HBO处理后第1,5,10,15,20天各8只。用流式细胞仪测定COP大鼠在不同时间段海马神经细胞线粒体膜电位及海马神经细胞凋亡细胞相对百分比（％）的变化和HBO治疗后的改变。结果CO组在COP后大鼠海马神经细胞线粒体膜电位在第1,5,10天降低（P＜0．01－0．05）;CO＋HBO组在第1,5天降低（P＜0．01－0．05）。CO组COP后大鼠海马神经细胞凋亡细胞相对百分比在第1,5,10,15,20天高于对照组（P＜0．01）;而CO＋HBO组只在第1,5,10天高于对照组（P＜0．01）。结论COP后大鼠海马神经细胞线粒体膜电位降低,凋亡细胞数增加,并持续很长时间,而HBO处理可缩短线粒体膜电位降低的减少凋亡细胞数百分比。     

不同高压氧治疗方案对急性一氧化碳中毒受损心肌的疗效分析

目的 探讨不同高压氧(hyperbaric oxygen,HBO)治疗方案对急性一氧化碳(carbon monoxide,CO)中毒受损心肌的影响.方法 对2006年10月至2010年3月收治的155例重症CO中毒患者进行HBO常规治疗(常规组,75例)和HBO改进治疗(改进组,80例).(1)常规组治疗方案:治疗压力0.25 MPa,加压20 min,稳压后吸氧2次,每次30 min,中间间歇10 min,减压20 min出舱.每日1次,12次为1个疗程,治疗9-68次.(2)改进组方案:前5 d采用HBO常规治疗,以后采用减小治疗压力、缩短吸氧时间、增加吸氧间隔、间歇给氧的治疗方案,治疗压力0.20 MPa,稳压吸氧4次,每次10min,中间间歇5 min,减压20 min出舱.连续治疗3 d后间隔1 d,10 d为1个疗程.2组患者使用相同的药物治疗方案.统计分析常规组和改进组ST-T变化及血清心肌酶变化.结果 改进组与常规组相比ST-T恢复率(56%,28%)明显升高(P＜0.05),HBO治疗第3天和第6天ST-T加重率(第3天21%、25%.第6天16%、27%)明显降低(P＜0.01);2组血清心肌酶恢复率和加重率比较差异有统计学意义(P＜0.05.P＜0.01).结论 HBO改进方案对CO中毒患者受损心肌疗效较好.

Abstract：

Objective To investigate the effects of different hyperbaric oxygen ( HBO) treatment profiles on damaged myocardium induced by acute carbon monoxide poisoning. Methods One hundred and fifty-five serious cases of acute carbon monoxide ( CO) poisoning admitted into the hospital for treatment from October 2006 to March 2010 were randomly divided into the routine HBO treatment group (the routine group,75 cases) and the improved HBO treatment group (the improved group,80 cases). The treatment profile of the routine HBO treatment group: the patients were compressed for 20 min to the treatment pressure of 0.25 Mpa. Following stabilization at the said pressure, the patients breathed oxygen twice for 30 min plus 10 min, once a day. The whole treatment course consisted of 12 sessions, with the patients receiving HBO treatments from 9 to 68 times. The treatment profile of the improved HBO treatment group: the patients were given routine HBO treatment in the first 5 days, then, received improved HBO treatment, with a treatment profile of lower pressure (0.20 Mpa) , shorter oxygen-breathing time, lengthening of oxygen-breathing intervals and intermittent oxygen breathing. Total oxygen-breathing time was 4 times, each for 10 min plus 3 times each for 5 min. Then, the patients were decompressed to the surface following 20-min oxygen-breathing decompression. The patients received treatment for a succession of 3 days, then, had 1-day interval, and the whole treatment course consisted of 10 sessions. Changes in ST-T and myocardial enzymes of both the routine HBO treatment group and the improved HBO treatment group were measured and analyzed. Results ST-T recovery rate of the improved HBO treatment group increased (56% ,28% ) obviously, when compared with that of the routine HBO treatment group(P ＜ 0. 05). ST-T worse rate decreased significantly following HBO treatment on the 3rd and 6th days (21% and 25% on the 3rd day, 16% and 27% on the 6th day) respectively (P＜0.01). Statistical differences could be seen in the myocardial recovery rate and worse rate, when a comparison was made between them (P＜0. 05, P＜0. 01). Conclusions The improved HBO treatment profile showed better therapeutic effect on damaged myocardium induced by CO poisoning. This treatment profile should be used instead of other treatment profiles.     

Hypoxemia with air breathing periods in U.S. NAVY Treatment Table 6.

Air breathing is used to lessen hyperbaric oxygen (HBO2) toxicity. Hypoxemia could occur during hyperbaric air breathing in patients with lung dysfunction, although this has not been previously reported. We report two cases of hypoxemia during air breathing with two patients treated with the US Navy Table 6. Patient 1 was an 11-year-old male with cerebral gas embolism (during cardiac transplantation), patient 2 was a 66-year-old female with cerebral gas embolism from a central venous catheter accident. Both were mechanically ventilated. We monitored arterial blood gas (ABG) during therapy. In both patients, ABG measurements showed hypoxia during the first air breathing period at 1.9 atm abs (192.5 kPa). If patients require > or = 40% inspired oxygen before HBO2 therapy, oxygenation monitoring is advisable during air breathing periods, especially at lower chamber pressures (< or = 2.0 atm abs).     

Hyperbaric oxygen for post-concussion syndrome: design of Department of Defense clinical trials

The current wars in the Middle East have resulted in between 10-20% of U.S. service members with mild traumatic brain injury (mTBI). While anecdotal reports have associated hyperbaric oxygen (HBO2) with improved outcomes after mTBI, controlled research is lacking. The Department of Defense (DoD), in collaboration with the Department of Veterans Affairs (DVA), has a comprehensive program examining this issue. The DoD's four randomized controlled trials will enroll a total of 242 service members with post-concussion syndrome and expose them to a range of control, sham and HBO2 conditions for 40 sessions over a period of eight to 11 weeks. Compression pressures will range from 1.2 atm abs (sham) to 2.4 atm abs, and oxygen concentration will range from room air (sham and control) to 100%. Outcomes measures include both subjective and objective measures performed at baseline, at exposure completion, and at three to 12 months' follow-up. This integrated program of clinical trials investigating the efficacy of HBO2 in service members with persistent symptoms following mTBI exposure will be important to define practice guidelines and, if needed, for the development of definitive clinical trials in this population.     

高压氧对急性一氧化碳中毒大鼠血清蛋白脂质蛋白质抗原、抗体的影响

目的 观察急性一氧化碳中毒(acute carbon monoxide poioning,ACOP)大鼠血清中蛋白脂质蛋白质(proteolipid protein,PLP)抗原、抗体的变化,探讨免疫机制在ACOP中的作用以及高压氧(HBO)治疗可能的作用机制.方法 202只大鼠按随机数字表法分为3组:染毒组(CO组),高压氧组(HBO组),常压氧组(NBO组).采用静态一氧化碳吸入法建立ACOP大鼠模型.染毒前及染毒后即刻、100 min和3、7、10、20 d取腹主动脉血,用ELISA法测定血清PLP抗原、抗体的含量.结果 染毒后即刻CO组、HBO组和NBO组PLP抗原及抗体均较染毒前升高(P＜0.05).HBO组100 min时PLP抗原低于CO组(P＜0.05);3、7 d时PLP抗体低于CO组(P＜0.05);3、10 d时HBO组PLP抗体低于NBO组(P＜0.05);7、20 d时NBO组PLP抗体低于CO组(P＜0.05).结论 ACOP后大鼠存在自身免疫反应及髓鞘损伤,及时、规律的HBO治疗可减轻髓鞘损伤.     

Hyperbaric oxygen therapy in two patients with non-arteritic anterior optic neuropathy who did not respond to prednisone

Recent advances in understanding the effects of hyperbaric oxygen (HBO) on retinal anoxia gave rise to new interest in the possibility of using it as therapeutic treatment for ischemic conditions of the retina and optic nerve. Two patients with non-arteritic anterior ischemic optic neuropathy due to a high-grade ophthalmic artery stenosis were treated with HBO at 2 atm abs in an effort to increase oxygen delivery for the eye. Both patients showed marked improvements of visual acuity and visual field 3-5 months following the event. Our results are intriguing although the achieved improvement could be coincidental.     

Questionnaire results of hyperbaric oxygen therapy for acute carbon monoxide poisoning in Japan

Carbon monoxide (CO) poisoning results in not only severe psychoneurological disorders, but can also cause secondary delayed psychoneurological disorders. Therefore, timely and appropriate treatment in the acute stage is crucial to prevent such direct neurological damage and secondary disorders. However, various conflicting results have been reported in studies of CO poisoning treatment, and the efficacy of hyperbaric oxygen therapy (HBO2T) for CO poisoning has not been established. This retrospective multi-institutional study was performed by the questionnaire in 1667 cases of acute CO poisoning in Japan. The effectiveness of HBO2T for CO poisoning was evaluated based on prognoses in cases and various classes of hospital based on the grade of their positive stance regarding HBO2T. The results showed that the prognosis in the group treated with HBOT was significantly better than that in the group treated with normobaric oxygen therapy (NBO2T) (P < 0.01), thus confirming the effectiveness of HBO2T for CO poisoning. Furthermore, while hospitals were separated into three groups according to their indication criteria for HBO2T, the ineffective ratio of NBO2T was dependent on the indication criteria, even though the effective ratio of HBO2T was the same in all three groups. In conclusion, a retrospective multi-institutional study showed that HBO2T is an effective form of therapy for CO poisoning.     

高压氧对急性一氧化碳中毒大鼠下丘脑-垂体-肾上腺轴的作用研究

目的探讨高压氧(HBO)治疗对急性一氧化碳(CO)中毒大鼠下丘脑-垂体-肾上腺(HPA)轴的作用。方法将36只大鼠按照随机数字表法分为正常对照组、CO中毒组和HBO治疗组各12只。建立急性CO中毒大鼠模型,给予HBO治疗7 d后,采用转录组测序(RNA-seq)进行各组大鼠脑组织基因检测,采用实时定量PCR(RT-PCR)对RNA-seq检测的差异基因阿片黑素促皮质激素原(POMC)进行分析;采用酶联免疫吸附法检测大鼠血清促肾上腺皮质激素(ACTH)和皮质醇(COR)的水平;采用免疫组化和免疫印迹法检测大鼠脑内POMC蛋白和ACTH蛋白受体(ACTHR)的表达。结果 RNA-seq和RT-PCR结果显示,CO中毒7 d后,大鼠下丘脑POMC基因表达显著升高(P<0.05),HBO处理使其表达降低(P<0.05)。与对照组相比,CO中毒组大鼠大脑皮层POMC表达升高(P<0.05), HBO治疗组较CO中毒组表达减少(P<0.05);CO中毒组大鼠大脑皮层ACTHR表达升高(P<0.05),但HBO治疗组与CO中毒组之间差异无统计学意义(P>0.05)。血清ACTH和COR水平检测结果显示,CO中毒组ACTH和COR显著增加(P<0.05),HBO治疗使其水平降低(P<0.05)。结论急性CO中毒可通过POMC-ACTH-COR途径激活HPA轴,HBO可能通过抑制HPA轴上相关基因、蛋白和激素水平的过度激活而发挥治疗作用。     

高压氧对急性一氧化碳中毒患者血浆一氧化氮、内皮素-1含量的影响

目的　观测急性一氧化碳 (CO)中毒患者血浆一氧化氮 (NO)、内皮素 - 1(ET- 1)含量的变化及高压氧 (HBO)的影响。方法　 6 6例 CO中毒的患者被分为轻、中、重度三组 ,分别用硝酸还原酶法、放免分析法测定治疗前后三组患者及对照组的 NO、ET- 1含量的变化。结果　 HBO治疗前不同中毒程度组患者的血浆 ET- 1的含量较对照组明显升高 ,而 NO的含量则显著降低 (P<0 .0 1) ,同时各组间差异均有显著性 ;HBO治疗前后比较发现 ,HBO治疗 1次后 NO、ET- 1较治疗前有明显变化 ,但仍明显高于对照组 ;而 10次 HBO治疗后接近对照值。结论　急性 CO中毒患者血浆 ET- 1的升高及 NO的降低参与 CO造成的意识障碍的发生过程 ;这两个指标的变化可用于判断 CO中毒意识障碍程度及 HBO的疗效 ;HBO治疗对 NO、ET- 1含量的变化有有益的调节作用 ,可改善 CO的病理损害作用。     

高压氧对急性CO中毒患者血清心脏肌钙蛋白T含量的影响(论著)

目的：观察高压氧（HBO）对急性一氧化碳（CO）中毒患者血清心脏肌钙蛋白T（troponinT，TnT）含量变化的影响，并探讨HBO对心肌损伤的疗效及机理。方法：对17例急性CO中毒患者，分别于HBO治疗前和1次治疗后评定Glasgow分数，同时测定血清TnT。对其中6例急性中、重度CO中毒患者在5次HBO治疗后复测血清TnT含量。结果：HBO治疗前后比较，急性轻度CO中毒患者血清TnT含量无显著差异（P＞0．05），急性中、重度CO中毒患者血清TnT含量显著下降（P＜0．05）；而6例急性中、重度CO中毒患者血清TnT含量，在HBO治疗1次、5次后均较治疗前非常明显下降（P＜0．01）。结论：急性中、重度CO中毒均有心肌损伤；HBO治疗可降低血清TnT，表明是治疗急性CO中毒心肌损伤的有效方法。     

高压氧治疗一氧化碳中毒继发急性脑病及心肌损害105例疗效观察

目的探讨高压氧(HBO)治疗一氧化碳(CO)中毒继发急性脑病及心肌损害的临床疗效。方法回顾性分析2015年3月至2020年3月山东淄博矿业集团中心医院高压氧科收治的CO中毒患者451例,其中发生急性脑病105例,且均继发不同程度的心肌损害。给予脱水、营养神经、改善循环、促醒、保护脏器、抗感染及其他支持对症治疗的同时,予以HBO治疗2~3个疗程。所有患者治疗前后检测碳氧血红蛋白(COHb)及肌钙蛋白I(cTnI)、肌酸激酶(CK)、肌酸激酶心肌同工酶(CK-MB)和乳酸脱氢酶(LDH)等水平;采用12导联心电图机描记心电图的动态变化,同时经腰椎穿刺行脑脊液压力测定。结果CO中毒后入院血生化检测105例患者COHb%为40.3%~54.7%,平均为(44.5±7.9)%;cTnI、CK、CK-MB、LDH等心肌酶谱均明显升高,为正常值的5~10倍。105例患者心电图均出现显著异常;颅内压为185~230 cmH2O,平均为(210.6±22.9)cmH2O。综合治疗2~3个疗程后,COHb%为1.3%~4.7%,平均为(3.2±0.6)%;cTnI、CK、CK-MB、LDH等心肌酶谱均恢复至正常值。颅内压为160~178 cmH2O,平均为(166.4±11.9)cmH2O。治疗后95例患者(90.5%)心电图逐渐恢复正常;10例心电图异常患者(9.5%)中,5例为心肌供血不足,3例房性早搏,2例室性早搏。经统计学比较,治疗前后上述指标差异均有统计学意义(P<0.05或P<0.01)。结论CO中毒容易继发急性脑病及心肌损害,HBO综合治疗CO中毒继发急性脑病及心肌损害疗效显著,可为临床治疗提供借鉴。     

高压氧对CO中毒大鼠海马中钙离子cGMP及血浆NO含量的影响

目的　测定一氧化碳（ＣＯ）中毒大鼠海马中钙离子（［Ｃａ２＋ ］ｉ）浓度与环磷酸鸟苷（ｃＧＭＰ）含量以及血浆一氧化氮（ＮＯ）含量的变化,同时观察高压氧（ＨＢＯ）在其间的作用。方法　８６ 只实验大鼠被随机分成１１ 组,分别为正常（对照）组;ＣＯ 中毒后１、３、５、１０、２０ 天５个组（ＣＯ组）;ＣＯ中毒后＋ ＨＢＯ１、３、５、１０、２０天５ 个组（ＣＯ＋ ＨＢＯ组）。分别用流式细胞仪测定大鼠海马中钙离子浓度和用酶免法测定海马神经元内ｃＧＭＰ含量,再用分光光度法测定大鼠血浆ＮＯ含量。结果　ＣＯ组海马中［Ｃａ２＋ ］ｉ浓度在ＣＯ中毒后第３、５、１０ 天和ｃＧＭＰ含量在第１、３、５、１０ 天明显低于对照组（Ｐ＜ ０．０１）,均于第２０ 天接近对照组（Ｐ＞ ０．０５）;血浆ＮＯ浓度在中毒后第１、３、５、１０ 天明显低于对照组（Ｐ＜ ０．０１）,至第２０ 天仍未恢复正常（Ｐ＜ ０．０５）。而ＣＯ＋ ＨＢＯ组海马中［Ｃａ２＋ ］ｉ浓度和ｃＧＭＰ含量以及血浆ＮＯ浓度在ＣＯ中毒后虽有变化但与ＣＯ组比,各时期数值均较接近对照组。并在第１０ 天后恢复正常。结论　ＣＯ中毒后,大鼠海马神经元细胞内钙离子、ｃＧＭＰ与血浆ＮＯ含量均降低,并持续较长时间。ＣＯ中     

Efficacy of hyperbaric oxygen on survival of random pattern skin flap in diabetic rats.

OBJECTIVES: This study was designed to determine if hyperbaric oxygen improved random pattern skin flap survival in diabetic rats. METHODS: Cranially-based, 4 x 10 cm dorsal skin flaps were raised in 38 diabetic rats induced by streptozocin (STZ). The animals were randomly divided equally into two groups. Group A was a control group observed in the room air and Group B was the experimental group, which received hyperbaric oxygen (HBO2) therapy. The HBO2 regimen consisted of 90 minutes of treatment with 100% O2 at 2.5 ATA (atmosphere absolute ATA) per day for 7 consecutive days. On the 7th postoperative day, we measured the necrotic flap area and the new growth number of capillary vessel and the granulation tissue thickness. RESULTS: The percentage of necrosis flap area for group A was 50.5 +/- 10.5%; for group B it was 38.5 +/- 9.3%. The reduction in necrosis flap area was highly significant (p < 0.01) compared with controls. Also, new-growth capillary vessel and granulation tissue thickness were statistically different between the two groups. CONCLUSIONS: The findings of this study demonstrated beneficial effects of HBO2 in improving diabetic rat dorsal skin flap survival.     

Hyperbaric oxygen treatment for carbon monoxide poisoning in pregnancy: a case report.

Carbon monoxide (CO) poisoning is one of the most common forms of poisoning in the United States. When CO poisoning occurs in the pregnant patient, it is extremely toxic to the mother and fetus in terms of central nervous system disorders and delayed central nervous system sequelae. Controversy exists in treating the pregnant patient with hyperbaric oxygen (HBO) because of the unknown effects of high partial pressures of oxygen on the fetus. HBO therapy is beneficial in CO poisoning because of its effect of first increasing oxygen concentration and causing a shift in the oxygen dissociation curve from the left to the right. Second, by causing a diminished CO interaction with cytochrome oxidase, HBO allows mitochondria to use oxygen more effectively. Third, HBO may reduce lipid peroxidation which may be responsible for neurological deterioration and delayed central nervous system sequelae. Fourth, decreased CO influence through HBO may reduce changes in the myocardium as a result of CO poisoning, if cardiovascular disease is already present. A case study of successful HBO therapy used during pregnancy is presented and effects of CO on the fetus are discussed.     

Hyperbaric oxygenation therapy enhances the protective effect of moderate hypothermia against forebrain ischemia in the gerbil hippocampus.

Moderate hypothermia may have a beneficial effect on the neurological outcome. However, ischemic deterioration such as brain swelling during rewarming has been reported as a notable complication after successful therapeutic cerebral hypothermia. In this study, we investigated the effects of hyperbaric oxygenation during rewarming. Forebrain ischemia was produced in 24 gerbils and sham ischemia in 8 animals. Then ischemia-treated animals were divided into 3 groups, whole-body moderate hypothermia (31 degrees C for 60 min) and hyperbaric oxygenation (HBO2) (2- atmosphere absolute for 60 min using 100% oxygen) during rewarming group (n = 8), moderate hypothermia without HBO2 group (n = 8), and sham treatment without hypothermia and without HBO2 group (n = 8). Both the hypothermia group (77.9 +/- 48.1 neurons per mm, mean +/- SD) and hypothermia + HBO2 group (127.6 +/- 29.7 neurons per mm,) showed significant preservation of CA1 pyramidal neurons in the hippocampus compared to that in the sham treatment group (6.4 +/- 2.7) (p < 0.01). Furthermore, the hypothermia + HBO2 group showed significantly greater preservation of CA1 pyramidal neurons than the hypothermia group (p < 0.05). These results suggest that HBO2 during rewarming preserves the protective effect of hypothermia against ischemic neuronal damage.     

早期高压氧治疗对急性颅脑外伤患者失语症的疗效观察

目的 研究早期高压氧(HBO)治疗对急性颅脑外伤患者失语症的疗效.方法 将2004年1月至2007年8月在我院住院的62例急性颅脑外伤患者分为HBO治疔组和常规治疗组,常规治疗组采用临床常规治疗,HBO治疗组在常规治疗的基础上,实施24～48次HBO治疗,并且在治疗结束后1年内每3个月进行1次随访.在治疗前、后分别采用西方失语成套测试法(western aphasia,WAB)检测并进行CT检查,对他们的语言功能和恢复情况进行评价和比较.结果 HBO治疗组显效率(83.8%)显著高于常规治疗组(54.8%),经x2检验P＜0.05;CT检查证实患者病变部位阻塞的血管已经恢复冉通或已获得重建.结论 早期HBO治疗有利于促进或恢复患者的语言功能.