早期高压氧综合治疗对颅内动脉瘤夹闭术后脑血管痉挛及神经功能的影响

目的 研究早期高压氧综合治疗对颅内动脉瘤夹闭术后脑血管痉挛及神经功能的影响。方法 选 取2013 年1 月-2017 年1 月于该院神经外科行颅内动脉瘤夹闭术的患者106 例作为研究对象，随机分为观察 组（53 例）与对照组（53 例）。术后两组均给予常规治疗，观察组加用高压氧综合治疗。两组患者结束治疗 出院时对其进行格拉斯哥结局评分（GOS）、日常生活活动能力评分（ADL）以及神经功能缺损评分（NFD）， 于开始综合治疗前、综合治疗15 d 以及综合治疗30 d 测量大脑中动脉血流速度并判定两组患者发生脑血管 痉挛的例数。结果 两组治疗后GOS、ADL 以及NFD 评分差异有统计学意义（P <0.05），观察组GOS 及 ADL 评分高于对照组，NFD 评分低于对照组。进行综合治疗前两组患者大脑中动脉血流速度及脑血管痉挛 例数差异无统计学意义（P >0.05），而经过治疗15 ～ 30 d 综合治疗后两组患者象大脑中动脉血流速度及脑血 管痉挛例数差异有统计学意义（P <0.05），观察组大脑中动脉血流速度慢于对照组，脑血管痉挛例数少于对照 组。结论 早期高压氧综合治疗对颅内动脉瘤夹闭术后患者的神经功能恢复有积极意义，并能减少脑血管痉 挛的发生。

Influence of early hyperbaric oxygen complex treatment on cerebral vasospasm and neural function after intracranial aneurysm clipping

Objective To research on influence of early hyperbaric oxygen complex treatment on cerebral vasospasm and neural function in patients after intracranial aneurysm clipping. Methods A total of 106 cases undergoing cerebral aneurysm clipping in the Department of Neurosurgery in our hospital between January 2013 and January 2017 were enrolled and randomly divided into observation group (53 cases) and control group (53 cases). The two groups were given regular therapy after operation, the observation group was continued with hyperbaric oxygen complex treatment. GOS, ADL and NFD scores were evaluated at discharge after treatment in the two groups. The middle cerebral artery velocity was measured and the number of cases of cerebral vasospasm was determined before complex treatment, after 15 and 30 days of complex treatment. Results There were significant differences in GOS, ADL and NFD scores between the two groups after therapy (P < 0.05), GOS and ADL scores in the observation group were higher than those in the control group, while NFD score was lower than that in the control group. There was no statistical difference in the middle cerebral artery velocity or the number of cases of cerebral vasospasm between the two groups before complex treatment (P > 0.05); however, the differences in the middle cerebral artery velocity and the number of cases of cerebral vasospasm were statistically significant between the two groups after 15 and 30 days of complex treatment (P < 0.05), the middle cerebral artery velocity in the observation was slower than that in the control group, the cases of cerebral vasospasm in the observation were fewer than those in the controls. Conclusions Early hyperbaric oxygen complex treatment has the positive meaning to recovery of nerve function after intracranial aneurysm clipping and can also reduce the occurrence of cerebral vasospasm.