高压氧治疗过程中诱发脑梗死的危险因素6例分析

背景传统观点认为高压氧可以防治脑梗死,但在高压氧治疗中有诱发脑梗死的病例报告.目的分析高压氧过程中诱发脑梗死的危险因素.设计以患者为观察对象的病例分析.单位广州军区广州总医院高压氧科.对象观察对象为1996-12/1998-03广州军区广州总医院行高压氧治疗的的192例住院患者,男127例,女65例;年龄9～78岁.接受高压氧治疗中发生脑梗死的患者共6例,男女各3例;年龄51～76岁.方法对192例行高压氧治疗患者及其中发生的6例脑梗死患者的背景因素进行分析.主要观察指标患者的症状、体征以及头颅CT或MRI变化.结果按意向处理分析,192例患者进入结果分析.①高压氧治疗过程中脑梗死发生率为0.3%(6/192).②发现高压氧诱发脑梗死以年龄≥60岁、高血压病、高脂血症、原有脑梗死(或脑出血)、高黏血症及糖尿病等基础疾病为危险因子,危险因子簇集4个以下者不发病,4个或4个以上者发病率大为增加.结论危险因子的簇集性水平与高压氧诱发脑梗死发生概率有密切关系.

Risk factors to induce cerebral infarction during hyperbaric oxygen treatment: A 6-case report

BACKGROUND: It is commonly believed that hyperbaric oxygen (HBO)plays a neuroprotective role in the prevention and treatment of cerebral infarction (CI), however hyperbaric oxygen therapy (HBOT)-induced CI was also reported.OBJECTIVE: To investigate the risk factors of HBOT-induced CI.DESIGN: Case analysis with patients as subjects.SETTING: At the Department of Hyperbaric Oxygen of Guangzhou General Hospital of Guangzhou Military Command Area of Chinese PLA.PARTICIPANTS: Totally 192 inpatients receiving HBOT were selected from the Department of Hyperbaric Oxygen of Guangzhou General Hospital Guangzhou Military Command Area of Chinese PLA between December 1996 and March 1998, including 127 males and 65 females with age ranging from 9 to 78 years old. Totally 6 patients, 3 males and 3 females, suffered from CI during HBOT, with the age from 51 to 76 yeas.METHODS: The background factors of 192 patients who HBOT METHODS and 6 cases with induced CI were analyzed.MAIN OUTCOME MEASURES: Symptoms, signs and skull CT or MRI.RESULTS: Data of 192 patients were dealt with intentionally and all were statistically analyzed without miss. ① The incidence of CI during HBOT was 0.3% (6/192). ② The risk factors of HBOT-induced CI included: age of ≥ 60 years, hypertension, hyperlipidemia, primary CI or cerebral hemorrhage, blood hyperviscosity and diabetes, and the incidence would greatly increased in those who has 4 or more than 4 risk factors, but seldom with less than 4 risk factors.CONCLUSION: The cluster level of risk factors was closely related with the incidence of HBOT-induced CI.