董永尧 石祥飞 张宗胜 王德勇 陈雅倩

[摘要]目的探討早期高压氧综合治疗对脑出血患者临床疗效的影响。方法选择2020年7—12月在邳州市人民医院诊断治疗的高血压脑出血患者80例为研究对象，随机分为两组。两组均给予常规治疗，观察组在此基础上家用高压氧综合治疗。分别于治疗前及治疗3个月采用Fugl-Meyer 运动功能评分法（FMA）评价患者肢体运动功能，采用 Barthel 指数（BI）评价患者生活质量。采用格拉斯哥昏迷评分（GCS）评价患者昏迷指数改善情况。结果治疗后两组 FMA 较治疗前提高显著，与治疗前比较差异有统计学意义（ P <0.05）;治疗后，观察组 FMA 评分（78.74±5.26）分，与对照组比较，差异有统计学意义（ P <0.05）。治疗后，两组 BI 评分显著较治疗前高，与治疗前比较，差异有统计学意义（P <0.05）;治疗后，观察组 BI （72.12±6.48）分，与对照组比较差异有统计学意义（ P <0.05）。治疗后两组 GCS 评分显著高于治疗前，差异有统计学意义（ P <0.05）;治疗后，观察组 GCS 评分（13.61±0.22）分，显著高于对照组，差异有统计学意义（ P <0.05）。结论早期高压氧综合治疗可显著改善脑出血患者的临床效果，改善肢体运动功能，提高患者生活质量。

[关键词]高压氧;早期;脑出血; Barthel 指数;Fugl-Meyer 评分; GCS 评分

[中图分类号] R743.34  [文献标识码] A   [文章编号]2095-0616（2021）24-0188-04

Exploration of the clinical effect of early hyperbaric oxygen comprehensive therapy on patients with intracerebral hemorrhage

DONGYongyao1 SHIXiangfei1 ZHANGZongsheng1 WANGDeyong1 CHENYaqian

1.Department of Neurosurgery， the People's Hospital of Pizhou， Jiangsu， Pizhou 221300， China;2. Department of Pharmacy， the People's Hospital of Pizhou， Jiangsu， Pizhou 221300， China

[Abstract] Objective To explore the clinical effect of early hyperbaric oxygen comprehensive therapy on patients with intracerebral hemorrhage. Methods Eighty patients with hypertensive intracerebral hemorrhage diagnosed and treated in the People's Hospital of Pizhou from July 2020 to December 2020 were randomly divided into two groups . Both groups were given conventional treatment， while the observation group was additionally treated with hyperbaric oxygen comprehensive therapy on that basis. Fugl-Meyer assessment （FMA） scale was used to evaluate the limb motor function of patients before treatment and after 3-month treatment， and Barthel index （BI） was used to evaluate the quality of life of patients. Glasgow coma scale （GCS） was used to evaluate the improvement of the coma index. Results After treatment， the FMA scores of the two groups increased significantly compared with those before treatment， with statistically significant differences （P <0.05）. After treatment， the FMA scale of the observation group was 78.745.26， which was significantly different from that of the control group （P <0.05）. After treatment， the BI scores of the two groups were significantly higher than those before treatment， with statistically significant differences （P <0.05）. After treatment， the BI of the observation group was （72.12±6.48）， which was significantly different from that of the control group （P <0.05）. After treatment， the GCS scores of the two groups were significantly higher than those before treatment， with statistically significant differences （P <0.05）. After treatment， the GCS score of the observation group was （13.61±0.22）， which was significantly higher than that of the control group （P <0.05）. Conclusion The early hyperbaric oxygen comprehensive therapy can significantly improve the clinical effect， limb motor function， and the quality of life of patients with intracerebral hemorrhage.

[Key words] Hyperbaric oxygen; Early stage; Intracerebral hemorrhage; Barthel index; Fugl-Meyer score; GCS score

原发性非外伤性脑实质出血是在原有高血压和脑血管病变的基础上，用力或情绪激动等外加因素使血压进一步骤然上升所致。患者可出现偏瘫、偏感觉障碍、偏盲，严重者可出现意识障碍，占位效应，甚至发生脑疝，危及患者死亡。高压氧治疗是在超过一个大气压的环境中呼吸纯氧，可提高氧分压、增加血氧和组织氧含量，提高氧的弥散率和有效弥散距离，促进侧支循环的形成，修复病变脑血管，改善脑代谢，恢复脑功能等作用。高压氧的治疗的原理主要是通过压力的作用引起血管收缩，减轻脑水肿，达到治疗效果[1-2]。高压氧能够提高机体的氧含量，帮助改善组织的缺血、缺氧症状[3-4]。研究显示，高压氧治疗脑血管疾病，可有效改善患者的预后[5]。但高压氧的治疗也存在一些风险，如导致气压伤等。……