早期高压氧治疗对急性创伤性脊髓损伤患者疗效的影响

【目的】探讨早期高压氧（HBO）治疗对急性创伤性脊髓损伤（SCI）患者疗效的影响。【方法】将86例急性脊髓损伤患者随机分为早期HBO组（A组）28例、晚期HBO组（B组）32例及对照组（C组）26例。C组采取常规处理（包括脱水剂、皮质激素、神经营养药物、胃黏膜保护药物、康复训练、针灸以及对症支持治疗等），A组患者在此基础上于SCI发生12h以内辅以HBO治疗，B组患者在此基础上于SCI发生3d以后辅以HB0治疗，于治疗前及治疗3个月后分别采用美国脊髓损伤协会（ASIA）评分、改良Barthel指数（MBI）及功能独立性评定量表（FIM）对患者进行测评。【结果】三组患者ASIA感觉、运动功能评分及MBI、FIM分值均较治疗前显著改善（P〈0．01），组间治疗后ASIA感觉功能评分比较有显著差异（P〈0．01），治疗后ASIA运动功能评分比较有显著差异（P〈0．05）。治疗后各组间MBI及FIM分值比较有显著性差异（P〈0．01）。【结论】HBO能显著改善急性SCI患者脊髓功能、日常生活活动能力及独立能力，且越早开始治疗效果越好。

Efficacy of Early Hyperbaric Oxygen Therapy in Acute Spinal Cord Injury

Objective] To explore the efficacy of early hyperbaric oxygen（HBO） therapy in patients with acute spinal cord injury（ASCI）. Methods] A total of 86 ASCI patients were randomly divided into early hyperbaric oxygen group（n=28）, late hyperbaric oxygen group（n=32） and control group（n=26）. The control group was treated with routine interventions（including dehydrator, cortical hormone, medication for neurotrophy, protective agents of gastric mucosa, rehabilitation training, acupuncture and supportive treatment）. The early HBO group was treated with HBO in addition to the routine treatments within 12 hours after the onset of ASCI, while the late HBO group was treated with HBO in addition to the routine treatments more than 3 days after the onset of ASCI. American spinal cord injury association（ASIA） assessment, modified Barthel index （MBI） and functional independence measure（FIM） before and 3 months after treatment were used to evaluate all patients. Results] Compared with before operation, the average scores of sensory and motor of ASIA, MBI and FIM improved significantly in all group after treatment （ P 〈0.01）. There were significant differences in the scores of sensory and motor of ASIA, MBI and FIM after treatment among all groups（ P 〈0.01 or P 〈0. 05）. Conclusion] HBO can significantly improve neurological function, activities of daily living （ADL） and independent capability in patients with ASCI. The earlier HBO treatment begins, the better the therapeutic effect is.