高压氧辅助治疗新生儿缺血缺氧性脑病50例

目的:观察高压氧对治疗新生儿缺血缺氧性脑病患儿的效果.方法:把诊断符合新生儿缺血缺氧性脑病诊断标准的100例患儿随机分为两组,对照组50例采用止惊,脱水,营养脑细胞,功能锻炼等治疗措施,治疗组50例在上述治疗同时加用高压氧治疗.结果:轻度患儿的治疗差别不大,但在中度和重度患儿治疗中存在着较大的差别.结论:高压氧治疗新生儿缺血缺氧性脑病疗效显著,值得推广.     

高压氧治疗新生儿缺血缺氧性脑病的护理

新生儿缺血缺氧性脑病(HIE),是目前临床较常见的重症,是新生儿期死亡和出现神经系统后遗症最常见的原因之一。1992年我科利用高压氧治疗2例,疗效明显,现将治疗及护理体会报告如下。一、病例介绍例1 男性,生后2小时因抽风3次,于1992年8月2日由我院产科转入。患儿生时脐带绕颈,生后呈中度窒息。体检:昏迷,口唇发绀,四肢肌张力减弱,呼吸浅促,前囟饱满,心肺无明显异常体征,拥抱反射及觅食反射均消失。查血生化正常。入院当天查血气分析pH7.353,PO_2 6.41kPa,PCO_2 5.84kPa,SO_2 0.8、DE—1.2mmol/L。血清酶活性定,GOT110.7u/L,CPK762u/L,LDH859u/L,头颅CT显示,两侧大脑半球呈大片低密度区。     

新生儿缺血缺氧性脑病的CT分析

目的 :分析CT对于新生儿缺血缺氧性脑病的诊断价值 ,从而更好地为临床早期诊断服务 ,以降低新生儿缺血缺氧性脑病的病死率 ,减少或避免后遗症。方法 :收集我院围产期有窒息病史、临床有缺血缺氧性脑病表现的患儿 86例 ,进行CT扫描。结果 :新生儿缺血缺氧性脑病的CT表现为颅内不同程度的低密度 ,并根据其病灶范围和大小及其对周围组织的影响将其分为三种类型。结论 :新生儿缺血缺氧性脑病 ,是新生儿常见疾病之一 ,如不及时明确诊断 ,进行治疗 ,病死率高 ,后遗症多。本文对新生儿缺血缺氧性脑病的CT诊断总结分析认为 :头颅CT是诊断新生儿缺血缺氧性脑病首选检查方法。     

32例新生儿缺氧性脑病的处理

新生儿缺血缺氧性脑病(HIE)是新生儿窒息后的严重并发症，病情重，病死率高，可遗留永久性脑神经功能障碾。我院自1999年1月～2001年12月共收治32例，现将其观察及论理体会报告如下。     

高压氧治疗新生儿缺氧缺血性脑病的护理体会

目的通过对高压氧治疗新生儿缺氧缺血性脑病(H IE)的疗效观察,总结病情观察和护理体会。方法通过对患儿在高压氧的治疗过程中的病情观察及护理措施,判定疗效,总结经验。结果 98例中显效68例,占69%,有效24例,占24%,治疗效果显著。结论在综合治疗和健脑治疗的基础上,配合高压氧治疗HIE,能降低其病死率,缩短病程,改善预后。     

高压氧舱治疗重型脑外伤患者术后的疗效观察

目的:探讨重症脑外伤患者高压氧(H-BO)治疗的临床效果.方法:重度脑外伤患者96例,入院时患者的GCS评分为3～7分,均于入院后行血肿清除术34例在伤后12～48小时内行早期HBO治疗,62例在脑水肿消退后行常规HBO治疗.两组均治疗2个疗程.结果:两组患者治疗后3周GCS评分和6个月后GOS评级出现明显差异.早期HBO治疗组预后明显优于常规治疗组.结论:早期的HBO治疗可以及时提高血氧含量,阻止恶性缺血缺氧的发生.重症脑外伤患者术后在可能的条件下应尽早行HBO治疗,以提高患者的生存质量.     

高压氧治疗新生儿缺氧缺血性脑病的临床分析

目的探讨高压氧治疗新生儿缺氧缺血性脑病的临床效果。方法将确诊为缺氧缺血性脑病的患儿随机分为试验组和对照组,试验组除给予常规治疗外,采用高压氧治疗,对照组仅给予常规治疗,比较两组新生儿治疗后的有效率。结果试验组患儿治疗有效率为92.54%,高于对照组,差异有统计学意义（x2=6.254,P〈0.05）。结论高压氧治疗新生儿缺氧缺血性脑病的临床效果好。     

高压氧舱内吸氧及针刺疗法治疗失眠症84例的疗效观察

目的:为了观察高压氧联合针刺疗法治疗失眠症患者近期及远期的疗效.方法:将无器质性病变的失眠症患者84例,随机分为高压氧舱内吸氧及针刺治疗组和单纯高压氧舱内吸氧两组,记录两治疗组的疗效,并加以分析.结果:针刺联合高压氧治疗组较单纯高压氧治疗组疗效明显改善.结论:高压氧舱内吸氧及针刺疗法治疗失眠症疗效更好,且无副作用.     

高压氧治疗新生儿缺氧缺血性脑病的不良反应及护理

新生儿缺氧缺血性脑病 (HIE)发病率高 ,且可出现严重的神经系统后遗症 ,影响儿童的生活质量 ,早期进行合理、有效的治疗是改善其预后的关键。高压氧 (HBO)治疗近年来运用广泛 ,并取得了一些疗效 [1] ,但操作程序要求严谨 ,稍有疏忽 ,易发生不良反应。2 0 0 0年 8月至 2 0 0 1年 5月 ,我科收治 HIE患儿 58例 ,在常规治疗的基础上行 HBO治疗 ,对其常见不良反应的护理对策进行了探讨。1　临床资料58例中 ,男 32例、女 2 6例 ,日龄≤ 2 d 9例 ,～ 7d 32例 ,～ 1 4d 1 7例。足月儿 47例 ,早产儿 (胎龄34～ 37周 ) 1 1例。出生时 1 min Apga…     

下肢止血带休克致缺血缺氧性脑病、肝肾功能衰竭1例

1病例资料 患者,男,59岁,因“车祸致伤左膝疼痛、活动障碍1h”于2013年1月25日入院。2年前因车祸伤行彩超检查证实右下肢腓肠肌静脉血栓,予活血、抗凝、降脂、溶栓等治疗后出院。     

高压氧处理对患者术后认知功能障碍的影响

背景 术后认知功能障碍(postoperative cognitive dysfunction,POCD)指的是患者手术麻醉后出现的认知功能减退,往往产生长久的严重后果,尤其是老年患者.高压氧(hyperbaric oxygen,HBO)处理作为一项辅助治疗措施目前已广泛应用于临床,大量研究证实HBO处理对大脑、心脏及肝等多种器官具有保护作用.已有研究者将HBO处理运用到认知功能障碍的研究中. 目的 探讨HBO处理对患者POCD的影响及其作用机制,为改善老年患者手术后认知功能及长期预后提供有效措施. 内容 对HBO处理、HBO处理用于POCD的研究情况及HBO改善POCD的作用机制进行综述. 趋向 HBO处理是近年来用于多脏器保护的重要措施,其脑保护作用为临床预防及改善POCD提供了新的思路.     

Hyperbaric oxygen treatment of postoperative neurosurgical infections

OBJECTIVE: To evaluate the clinical usefulness of hyperbaric oxygen (HBO) therapy for neurosurgical infections after craniotomy or laminectomy. METHODS: The study involved review of medical records, office visits, and telephone contacts for 39 consecutive patients who were referred in 1996 to 2000. Infection control and healing without removal of bone flaps or foreign material, with a minimum of 6 months of follow-up monitoring, were considered to represent success. RESULTS: Successful results were achieved for 27 of 36 patients, with a mean follow-up period of 27 months (range, 6-58 mo). One patient discontinued HBO therapy because of claustrophobia, and two could not be evaluated because of death resulting from tumor recurrence. In Group 1 (uncomplicated cranial wound infections), 12 of 15 patients achieved healing with retention of bone flaps. In Group 2 (complicated cranial wound infections, with risk factors such as malignancy, radiation injury, repeated surgery, or implants), all except one infection resolved; three of four bone flaps and three of six acrylic cranioplasties could be retained. In Group 3 (spinal wound infections), all infections resolved, five of seven without removal of fixation systems. There were no major side effects of HBO treatment. CONCLUSION: HBO treatment is an alternative to standard surgical removal of infected bone flaps and is particularly useful in complex situations. It can improve outcomes, reduce the need for reoperations, and allow infection control without mandatory removal of foreign material. HBO therapy is a safe, powerful treatment for postoperative cranial and spinal wound infections, it seems cost-effective, and it should be included in the neurosurgical armamentarium.     

Hyperbaric oxygen therapy attenuates renal ischemia/reperfusion injury in rats

OBJECTIVE: Renal ischemia/reperfusion (I/R) injury occurs in both native and transplanted kidneys. Hyperbaric oxygen (HBO) has been shown to prevent I/R injury in different tissues. The aim of this study was to evaluate the effect of HBO on renal I/R injury in rats. MATERIALS AND METHODS: Sprague-Dawley rats were randomly assigned to one of three groups. The Control group (n = 6) received right nephrectomy. The I/R (n = 6) and I/R+HBO groups (n = 6) received 30 min left renal ischemia followed by 24 h of reperfusion after right nephrectomy. The I/R+HBO group (n = 6) received additional HBO therapy for 60 min at 2.5 absolute atmospheres starting at the initial 15th minute of reperfusion. RESULTS: In the I/R group, blood urea nitrogen (BUN) and creatinine levels increased significantly compared with the Control and I/R+HBO groups (p < 0.05). BUN and creatinine levels were similar in the Control and I/R+HBO groups. Kidney samples from I/R group rats revealed severe tubular damage and neutrophil infiltration at histopathological examination. The animals treated with HBO showed markedly improved lesions and less neutrophil infiltration compared with the I/R group (p < 0.05). CONCLUSIONS: HBO exhibited marked protection against I/R injury in this study as measured using BUN and creatinine levels and renal histopathology. However, further studies are needed to clarify the renoprotective effect of HBO on I/R injury.     

Hyperbaric oxygen in the treatment of burns.

Since 1972, over 800 burn victims have been treated with hyperbaric oxygen at the Burn Center of Sherman Oaks Community Hospital in Los Angeles. HBO is used only as an adjuvant to standard resuscitation and is not intended to replace current accepted therapy. The results of the first three-year study program show definite changes in burn care delivery. There has been a definite decrease in the mortality as compared with our own predictions and statistics and with those of the N.B.I.E. In addition, a marked improvement in morbidity and a reduction in hospital stay were noted.     

Hyperbaric oxygen for the treatment of fournier's gangrene

PURPOSE: Fournier's gangrene is a necrotizing fasciitis of the genitalia that is associated with high morbidity and mortality. Groups at many institutions have initiated routine adjuvant hyperbaric oxygen (HBO) therapy. We examined whether HBO has made a difference in the morbidity, mortality and costs associated with treating this disease. We also analyzed predictors of extended hospital stay and mortality. MATERIALS AND METHODS: The records of patients with the hospital discharge diagnoses of Fournier's gangrene, necrotizing fasciitis, gangrene of the genitalia and scrotal gangrene from 1993 to 2002 were reviewed. Data concerning clinical presentation characteristics, hospital stay, complications, hospital charges and outcomes, including graft failure and death, were analyzed. RESULTS: A total of 42 patients were identified and followed a median 4.2 years. Of the patients 16 underwent surgical debridement and antibiotic therapy alone, and 26 were treated with HBO plus surgery and antibiotics. Overall disease specific mortality was 21.4%, that is 12.5% in the nonHBO group and 26.9% in the HBO group. Three or more complications occurred in 13% of nonHBO and in 19% of HBO cases, of which the most common was myocardial infarction. The skin graft failure rate was 6% (nonHBO) and 8% (HBO). Physical disability was a statistically significant predictor of extended hospital stay (p <0.01). There was a trend toward a correlation between known coronary artery disease and death (p = 0.2). A statistically significant difference was noted in average daily hospital charges in nonHBO vs HBO cases ($2,552 vs $3,384 daily, p <0.01). CONCLUSIONS: These data do not support routine HBO in the treatment of Fournier's gangrene. There was a trend toward higher morbidity and mortality in the HBO group, suggesting that treatment may have been given to patients who were more ill.     

复杂Lisfranc损伤的高压氧综合治疗

[目的]评价高压氧综合治疗复杂Lisfranc损伤的治疗效果.[方法]选取62例复杂Lisfranc损伤患者,分为高压氧组和对照组,测定两组患者治疗前后C-反应蛋白浓度,并以统一标准判断疗效,进行比较判定.[结果]高压氧组治疗效果明显率为81.5%,创面I期愈合占92.6%,对照组治疗效果明显率为68.6%,创面I期愈合占74.3%,疗效差异有统计学意义(P<0.05);治疗前两组间C-反应蛋白差异无统计学意义(P>0.05),治疗后高压氧组为(17.4±11.2)mg/L,对照组为(39.3 ±31.3)ms/L,差异有统计学意义(P<0.05).[结论]高压氧综合治疗复杂Lisfranc损伤结果明显优于常规手术治疗,有利于提高疗效和改善预后.