高压氧联用路路通治疗100例脑梗死的疗效观察

目的　探讨高压氧联用路路通治疗急性脑梗死的效果。方法　将 2 0 0例急性脑梗死患者随机分成两组。A组 :高压氧联合路路通治疗组 10 0例。B组 :单用路路通对照组 10 0例。HBO 10次为一疗程 ,共 2个疗程。结果　治疗后两组疗效比较有显著差异 ,高压氧组疗效显著高于对照组。结论　在脑梗死急性期患者 ,在进行常规药物治疗同时 ,加用高压氧治疗可提高疗效 ,降低致残率。     

高压氧联用路路通治疗100例脑梗死的疗效观察

目的 探讨高压氧联用路路通治疗急性脑梗死的效果。方法 将200例急笥脑梗死患者随机分成两组。A组；高压氧联合路路通治疗组100例。B组；单用路路通对照组100例。HBO10次为一疗程。共2个疗程。结果 治疗后两组疗效比较有显著差异。高压氧组疗效显著高于对照组。结论 在脑梗死急性期患者，在进行常规药物治疗同时，加用高压氧治疗可提高疗效，降低致残率。     

高压氧治疗脑瘤 脑动脉瘤术后患者的临床疗效

目的探讨高压氧对脑瘤、脑动脉瘤术后患者的治疗效果。方法按照随机数字表法将56例脑瘤、脑动脉瘤术后患者分为A、B组各28例,A组常规治疗,B组在A组基础上加用高压氧疗法,对比2组治疗前后日常生活能力、生存质量及疗效。结果 B组总有效率高于A组,差异有统计学意义(P0.05)。ADL评分及SF-36评分治疗后,B组患者均优于A组,差异有统计学意义(P0.05)。结论高压氧对脑瘤、脑动脉瘤术后患者治疗效果较好,可改善患者生活自理能力及生存质量。     

高压氧治疗贝尔面瘫临床观察

目的 探讨高压氧在治疗贝尔面瘫的临床疗效及其治疗机制.方法 将贝尔面患者瘫80例随机分为治疗组和对照组,对照组40例给予常规药物、红外线理疗治疗,治疗组40例在常规治疗的基础上加用高压氧治疗,2组疗程均为20 d.观察2组临床疗效.结果 治疗组总有效率92.5%,对照组为70.0%,2组差异有统计学意义(P<0.05).结论 在常规药物、理疗基础上联合应用高压氧治疗贝尔面瘫,可显著提高治疗效果,值得临床推荐.     

高压氧治疗脑梗死时机与疗效并与SOD、MDA的关系

目的观察高压氧治疗脑梗死时机与疗效、SOD、MDA的关系。方法将105例急性脑梗死患者随机分为3组,每组35例。A组:入院时常规治疗的同时进行高压氧治疗5个疗程(50次)。B组:入院时先常规治疗,发病14d时行高压氧治疗5个疗程。C组:仅进行常规治疗。评价3组治疗前后疗效、SOD、MDA的差异。结果 A组神经功能缺损积分明显改善,SOD含量升高、MDA含量下降,较B组、C组差异有统计学意义(P<0.05)。结论高压氧治疗早期脑梗死疗效明显提高。     

早期康复联合高压氧治疗急性脑梗死疗效观察

目的观察早期康复联合高压氧综合治疗急性脑梗死患者的疗效。方法将118例急性脑梗死患者随机分为对照组（39例）、康复组（40例）、联合组（康复＋高压氧治疗,39例）,3组患者均接受神经内科常规药物治疗,康复组早期介入康复治疗,联合组在康复组治疗的基础上加用高压氧治疗,比较3组的临床疗效。结果联合组疗效优于康复组及对照组,差异有统计学意义（P〈0.05或P〈0.01）。结论早期康复联合高压氧综合治疗能显著改善急性脑梗死患者的神经功能缺损,提高日常生活能力,更利于患者全面康复。     

高压氧治疗小儿急性肢体偏瘫疗效分析

目的观察高压氧联合药物治疗小儿急性肢体偏瘫的临床疗效。方法急性肢体偏瘫患儿76例,随机分为2组,高压氧组40例,在常规治疗基础上加高压氧治疗;常规治疗组36例。对高压氧组的不同病因、开始治疗时间及年龄与疗效的关系及2组间的预后进行对比分析。结果高压氧组治愈率72.5%,常规治疗组为36.1%,2组对比差异有统计学意义。结论高压氧联合治疗小儿急性肢体偏瘫可明显提高治愈率。     

高压氧治疗外伤性脑梗死的临床观察

目的　探讨高压氧治疗外伤性脑梗死患者的作用。方法　对 2 3例外伤性脑梗死患者 ,在采用常规药物治疗的基础上 ,伤后早期配合高压氧治疗。结果　高压氧治疗 3个疗程后 ,患者临床疗效显著 ,治愈率 82 6% ,GCS评分提高 ,CT示梗死面积减小。结论　高压氧治疗可作为外伤性脑梗死患者神经功能康复的重要手段。     

Bell氏面瘫106例疗效观察

目的 :根据面神经电图 (ENOG)检查 ,将Bell氏面瘫分成两组 ,观察三种治疗方案的疗效。方法 :A组示ENOG患侧损失在90 %以下。B组示ENOG患侧损失在 90 %以上 ;Ⅰ表示用扩血管营养神经药物治疗组 ,Ⅱ表示用扩血管营养神经药物加用皮质激素治疗组 ,Ⅲ表示在药物治疗的基础上加用面神经减压术治疗组。结果 :A组药物治疗好于B组 ,且部分B组患者需手术治疗。AⅡ、BⅡ组的药物疗效好于AⅠ、BⅠ组。结论 :以 90 %为ENOG检查的临床值是准确的。ENOG损失在 90 %以下时 ,用药物治疗大多可获得好的疗效。ENOG损失在 90 %以上时 ,药物治疗虽可获得一定的疗效 ,但仍有部分患者需手术治疗。     

敬告读者、作者

目的 探讨高压氧治疗外伤性脑梗死患者的作用。方法 对23例外伤性脑梗死患者，在采用常规药物治疗的基础上。伤后早期配合高压氧治疗。结果 高压氧治疗3个疗程后，患者临床疗效显著，治愈率82．6％，GCS评分提高，CT示梗死面积减小。结论 高压氧治疗可作为外伤性脑梗死患者神经功能康复的重要手段。     

高压氧及右正中神经电刺激对重型颅脑外伤患者的术后催醒作用

目的 探讨高压氧(HBO)及右正中神经电刺激(RMNS)对重型颅脑损伤患者术后催醒的影响. 方法 选择83例术后恢复期重型颅脑损伤患者,按随机数字表法分为治疗组(n=42)和对照组(n=41),其中对照组患者接受常规及对症治疗,治疗组在此基础上同时进行高压氧(HBO)及右正中神经电刺激(RMNS)治疗.3个月后比较2组患者的格拉斯哥昏迷评分(GCS)、格拉斯哥预后评分(GOS)、日常生活能力评分(ADL)、神经功能缺损评定(ESS)和远期生活质量评分(KPS),采用经颅三维多普勒彩色超声(TCD)和脑地形图(BEAM)分别评定脑血流量和脑电活动的变化. 结果与对照组比较,治疗组患者治疗1、3个月时各项评分均有改善,差异有统计学意义(P＜0.05);TCD检查显示治疗组患者病灶局部脑血流量明显提高,对照组仅有17例患者病灶局部脑血流量较前有所提高;与对照组比较,BEAM显示治疗组患者治疗后弥漫性慢波明显减少. 结论 高压氧及右正中神经电刺激治疗能促进重型颅脑损伤患者脑组织和脑神经功能的恢复,促进意识水平的改善.     

Neuroprotection of hyperbaric oxygen therapy in sub-acute traumatic brain injury：not by immediately improving cerebral oxygen saturation and oxygen partial pressure

Although hyperbaric oxygen (HBO) therapy can promote the recovery of neural function in patients who have suffered traumatic brain injury (TBI), the underlying mechanism is unclear. We hypothesized that hyperbaric oxygen treatment plays a neuroprotective role in TBI by increasing regional transcranial oxygen saturation (rSO2) and oxygen partial pressure (PaO2). To test this idea, we compared two groups:a control group with 20 healthy people and a treatment group with 40 TBI patients. The 40 patients were given 100% oxygen of HBO for 90 minutes. Changes in rSO2 were measured. The controls were also examined for rSO2 and PaO2, but received no treatment. rSO2 levels in the patients did not differ signiifcantly after treatment, but levels before and after treatment were signiifcantly lower than those in the control group. PaO2 levels were signiifcantly decreased after the 30-minute HBO treatment. Our ifndings suggest that there is a disorder of oxygen metabolism in patients with sub-acute TBI. HBO does not immediately affect cerebral oxygen metabolism, and the underlying mechanism still needs to be studied in depth.     

高压氧对重型颅脑外伤患者血清和肽素的影响

目的探讨高压氧对重型颅脑外伤患者血清和肽素水平的影响及临床意义。方法选取重型颅脑损伤患者76例,随机将其分为对照组及研究组,研究组在对照组基础上予以高压氧治疗。比较研究组在高压氧治疗后、对照组于常规治疗后第1、2、3周结束次日血清和肽素水平;比较两组患者治疗后GCS评分变化。结果高压氧治疗作用下,与对照组相比较研究组患者血清和肽素水平在高压氧治疗后第1、2、3周结束时均降低(P0.05)。治疗3周后两组患者的GCS评分均较治疗前提高(P0.05),高压氧组患者GCS评分提高更加明显(aP0.05)。结论高压氧治疗能降低重型颅脑外伤患者血清和肽素水平并促进重型颅脑外伤患者康复,高压氧治疗有助于重型颅脑外伤患者康复可能与高压氧治疗下患者血清和肽素水平降低相关。     

脑外伤性癫痫的高压氧综合治疗

目的观察高压氧治疗对脑外伤性癫痫的治疗效果,并探讨其作用机制。方法对70例脑外伤性癫痫患者进行高压氧综合治疗,并与非高压氧治疗的50例进行疗效比较。 结果HBO组的有效率为94.3％,对照组的有效率为80.0％,两组的有效率有明显的统计学差异(x2=5.78,P<0.05)。 结论HBO治疗能缩短临床治疗时间,明显提高脑外伤性癫痫的疗效,且无毒副作用。     

高压氧治疗急性脑梗死的临床观察

目的观察高压氧治疗急性脑梗死的临床疗效和不良反应。方法选择发病1周内的急性脑梗死患者80例,并随机分为高压氧组和对照组各40例;对照组接受脑梗死常规药物治疗,高压氧组在对照组治疗的基础上给予高压氧治疗,氧舱压力2.0ATA,加压20min,戴面罩吸纯氧1h,中间休息10min,减压30min,共2h,1次/d,每次2h,连续治疗10d;治疗前及治疗后第7、14、21d采用欧洲卒中量表（ESS）评定患者神经功能,并观察治疗过程中的不良反应。结果2组在治疗后第14、21d与治疗前比较ESS评分均有明显增高（P〈0.05）;高压氧组神经功能评分ESS在治疗后第7、14d与对照组比较差异无显著性（P〉0.05）,在治疗后第21d优于对照组,差异有显著性（P〈0.05）;高压氧组无特殊不良反应。结论高压氧治疗能促进急性脑梗死患者神经功能恢复,是一种安全有效的治疗方法。     

Hyperbaric oxygen in traumatic brain injury

OBJECTIVES: This critical literature review examines historical and current investigations on the efficacy and mechanisms of hyperbaric oxygen (HBO) treatment in traumatic brain injury (TBI). Potential safety risks and oxygen toxicity, as well as HBO's future potential, are also discussed. METHODS: Directed literature review. RESULTS: Historically, cerebral vasoconstriction and increased oxygen availability were seen as the primary mechanisms of HBO in TBI. HBO now appears to be improving cerebral aerobic metabolism at a cellular level, namely, by enhancing damaged mitochondrial recovery. HBO given at the ideal treatment paradigm, 1.5 ATA for 60 minutes, does not appear to produce oxygen toxicity and is relatively safe. DISCUSSION: The use of HBO in TBI remains controversial. Growing evidence, however, shows that HBO may be a potential treatment for patients with severe brain injury. Further investigations, including a multicenter prospective randomized clinical trial, will be required to definitively define the role of HBO in severe TBI.     

高压氧早期治疗对高血压脑出血患者术后神经功能及血清hs-CRP的影响

目的探讨高压氧早期治疗对高血压脑出血（HICH）患者术后神经功能恢复及血清hs-CRP水平的影响。 方法将78例高血压性脑出血患者随机分为高压氧组（42例）和对照组（36例）。对照组给予开颅血肿清除手术、控制血压、脱水降颅压和营养神经等常规治疗,高压氧组在对照组的基础上于术后第5天开始高压氧治疗,每天1次,共20 d。观察2组患者的治疗有效率和入院时、手术后第5天及高压氧20 d后脑水肿程度、血清hs-CRP水平及两者之间的相关性。 结果高压氧组患者治疗后治疗有效率较对照组明显提高,差异具有统计学意义（P<0.05）;治疗后高压氧组和对照组脑水肿体积和血清hs-CRP水平均较治疗前明显降低,差异具有统计学意义（P<0.05）,而高压氧组脑水肿体积和血清hs-CRP减少程度显著高于对照组,差异具有统计学意义（P<0.05）;Pearson相关分析显示HICH患者血清hs-CRP水平与脑水肿程度之间呈显著正相关关系（P<0.05）。 结论高压氧早期治疗能显著促进高血压性脑出血患者神经功能的恢复,减轻患者脑水肿程度及降低血清hs-CRP水平。     

Continuous measurements of cerebral tissue oxygen pressure during hyperbaric oxygenation--HBO effects on brain edema and necrosis after severe brain trauma in rabbits

INTRODUCTION: Severe brain injury is one of the most frequent causes of severe disability in the young. In acute management of brain trauma, new approaches based on experimental animal investigations should be sought. METHODS: Twenty male, juvenile Chinchilla-Bastard rabbits received standardized cold-injury-induced-brain-trauma (CIBT). A metal probe (temperature -196 degrees C) was applied epidurally over 10 s. The hyperbaric oxygenation (HBO) group (n=10) underwent 90-min HBO sessions with 100% oxygen at 2.5 atmospheres absolute (1 h, 24+/-2 h, 48+/-2 h after CIBT). Cerebral tissue pO2-measurements were performed 60 min after CIBT, during the three HBO sessions and on day 4. The control group (n=10) underwent no treatment. Animals were sacrificed on day 4, and brains were analyzed histologically. RESULTS: In the HBO group, pO2 measurements showed a significant increase in pO2 between day 1 and day 4, whereas no significant changes were observed in the control group. During the first HBO session, mean pO2 was 169 mm Hg, during the second 305 mm Hg and during the third 420 mm Hg. The mean area of necrosis was 16.2 mm2 in the HBO group, in the control group 19.9 mm2. The areas of brain edema were significantly smaller in the HBO group. Mortality in the HBO group was 0%, in the control group 20%. CONCLUSION: HBO appears to be beneficial as an adjunct treatment of severe head trauma. To find optimal treatment protocols, further clinical studies must be developed.     

瘤周水肿明显的脑膜瘤术后高压氧治疗

目的 探讨高压氧(HBO)在瘤周水肿明显的脑膜瘤术后的治疗作用.方法 将232例瘤周水肿明显的脑膜瘤根据术前、术后平衡的原则分为HBO治疗组和对照组,各116例.HBO治疗组在对照组治疗的基础上,早期应用高压氧治疗,术后半个月统计两组患者的机能状态(KPS评分)、术区水肿体积,术后半年统计两组患者术区异常密度影体积和神经功能障碍例数,并做统计学分析.结果 两组患者术后3 d KPS评分及术区水肿体积差异无统计学意义(P>0.05);术后半个月HBO治疗组KPS评分高于对照组,术区水肿体积明显小于对照组,两组比较差异有统计学意义(P<0.05);术后半年HBO治疗组术区异常密度体积小于对照组(P<0.05),HBO治疗组出现过癫痫、失语或轻瘫等神经功能障碍的例数少于对照组(P<0.01).结论 术后早期应用高压氧治疗瘤周水肿明显的脑膜瘤,可减轻水肿体积,提高KPS评分和降低神经功能障碍的发生率,有较好的临床应用价值.     

Hyperbaric oxygen treatment induces dynamic ATPase activity changes in the rat brain following transient global cerebral ischemia-reperfusion*

BACKGROUND： Energy depletion, induced by ischemia or hypoxia, is one of the first events in neuronal injury. OBJECTIVE： To investigate the dynamic changes of Na^＋-K^＋-ATPase and Ca^2＋-ATPase activity in the rat brain following transient global cerebral ischemia-reperfusion （IR）, as well as the effects of hyperbaric oxygen （HBO） treatment. DESIGN, TIME AND SETTING： A randomized and controlled animal study was performed in the Department of Biochemistry and Molecular Biology, Capital Medical University between February and December 2006. MATERIALS： Clean-grade, female, Sprague Dawley rats were provided by the Animal Research Department of Capital Medical University （License number： SYXK11-00-0047）. Na^＋-K^＋-ATPase and Ca^2＋-ATPase kits were provided by Nanjing Jiancheng Bioengineering Institute （Nanjing, China）. A hyperbaric oxygen chamber （DWC150-300） was supplied by Shanghai 701 Medical Oxygen Chamber Factory （Shanghai, China）. METHODS： Sixty-three rats were randomly divided into nine groups： sham operated group （sham-O） as control, groups of IR, and groups treated with hyperbaric oxygen （HBO） after IR. Animal from the IR and HBO groups were sacrificed after four different survival intervals of 6, 24, 48 and 96 hours, respectively. Each group consisted of seven rats. The rats of HBO groups were placed into the hyperbaric chamber. The HBO chamber was flushed with pure oxygen for 5 minutes, followed by a gradual rise in pressure over 5 minutes and stabilization at 0.2 MPa. Then, pure oxygen was supplied for 45 minutes in stabilized pressure, followed by gradually reduced pressure over 15 minutes. The rats of the 6-h HBO group were placed into the HBO chamber following reperfusion for 3 hours on the first day, which was repeated on three consecutive days, always at the same time. Rats in the sham-O group and IR group remained under normal atmospheric pressure. MAIN OUTCOME MEASURES： The Na^＋-K^＋-ATPase and Ca^2＋-ATPase activity in rat brain homogenate