高压氧综合治疗持续植物状态280例

目的 探讨高压氧(HBO)综合治疗持续植物状态(PVS)的疗效以及影像学在PVS诊断中的意义.方法 对280例PVS患者进行了HBO综合血液磁极化治疗、药物治疗以及影像学等检查.结果 本组治愈85例,占30.4%;好转148例,占52.8%;未脱离PVS 43例,占15.2%,但全身状况改善;死亡4例占1.6%.280例PVS患者脑CT显示多种异常征象;76例MRI检查尚可见到中脑、脑干萎缩;32例脑(SPECT)显像显示脑不同部位血流灌注减低.随PVS的恢复,接受HBO综合治疗20～50次后影像学复查明显好转.结论 HBO综合治疗PVS的治疗方案疗效满意.脑SPECT显像可与CT、MRI互补,并可作为HBO综合治疗PVS判断疗效及预后的指标.

Comprehensive hyperbaric oxygen therapy of 280 cases of persistent vegetative state

Objective To investigate the effect of comprehensive hyperbaric oxygen (HBO) on 280 cases of persistent vegetative state (PVS) and the importance of radiological examination in the diagnosis of PVS.Methods Comprehensive HBO therapy combined with blood magnetization therapy and drugs treatment were administered to 280 patients with PVS.Results In a total of 280 PVS cases,85 were cured,accounting for 30.4%;148 cases improved,accounting for 52.8%;43 cases,accounting for 15.2% remained in the persistent vegetative state,but with overall improvement;4 cases died,accounting for 1.6%.Abnormal signs and symptoms could be found via cerebral CT in the 280 cases of PVS.Atrophy of mesencephalon and brain stem were revealed through MRI examination in 76 cases of PVS.Single photon emission computed tomography (SPECT) found that blood perfusion in different cerebral regions decreased in 32 cases of PVS.Following comprehensive HBO therapy coupled with other treatment for 20 - 50 times patients recovered from PVS to various degrees and radiological examinations revealed that signs and symptoms improved significantly.Conclusions The therapeutic effect of comprehensive HBO couple with other treatment on PVS was satisfactory.Cerebral SPECT imaging could be complementary to CT and MRI and it could be used as an index to forecast the therapeutic effect of comprehensive HBO treatment and prognosis of PVS.