高龄老年急性脑梗死患者的氧治疗应用

目的探讨高龄老年（≥70岁）急性脑梗死患者治疗中高压氧与舱外高流量氧的合理应用。方法对2010年4月至2012年3月收治共140例急性脑梗死患者，采用随机数字表法分为高压氧组（69例）和舱外高流量氧组（71例），两组患者均进行常规药物治疗，即应用改善微循环、营养神经等药物，以及康复治疗。高压氧组加用高压氧治疗、舱外高流量氧组加用舱外高流量氧治疗。疗效采用美国国立卫生院脑卒中量表（NIHSS）神经功能缺损评分并根据患者生活状态进行综合评定。结果舱外高流量氧组的总有效率高于高压氧组98．6％（70／71）比91．3％（63／69）]，差异有统计学意义（P〈0．05）。高压氧组和舱外高流量氧组治疗后NIHSS评分均较治疗前显著改善（15．6±1．8）分比（28．2±2．5）分和（10．4±1．7）分1：L（28．7±2．6）分]，差异有统计学意义（P〈0．05），且治疗后舱外高流量氧组NIHSS评分明显低于高压氧组（10．4±1．7）分比（15．6±1．8）分]，差异有统计学意义（P〈0．05）。舱外高流量氧组治疗依从性好于高压氧组，差异有统计学意义（P〈0．05）。结论高龄老年急性脑梗死患者应尽早行舱外高流量氧治疗，以促进疾病的康复。

Oxygen treatment on elderly patients with acute ischemic stroke

Objective To study the value of oxygen treatment on elderly patients with acute isehemic stroke. Methods From April 2010 to March 2012, a total of 140 cases of elderly patients with acute ischemic stroke for oxygen therapy combined with drug and rehabilitation were divided into two groups, outside high-flow oxygen group of 71 cases, hyperbaric oxygen group of 69 cases. The neurological functional defects scale was used to evaluate the effect. Two groups of patients were given conventional drug therapy including improving the microcirculation, vegetative neural drugs, and rehabilitation treatment. Results The total effectiveness respectively was 98.6% （70/71）, 91.3% （63/69）, and there was significant difference （P 〈 0.05 ）. After treatment, the nerve function damage grades of two groups respectively was （ 10.4± 1.7）, （ 15.6 ± 1.8 ） scores, and there was significant difference compared with that before treatment （28.2 ± 2.5 ）, （28.7 ± 2.6） scores 1 （P 〈 0.05 ）. There was significant difference in treatment adherence between two groups （P 〈 0.05）. Conclusion For patients of elderly patients with acute ischemic stroke, oxygen therapy is necessary, while outside high-flow oxygen therapy is better than hyperbaric oxygen therapy.