高压氧对缺血缺氧性脑病所致抑郁状态患者的临床疗效及其对血液流变学的影响研究

Clinical effect of hyperbaric oxygen on hypoxic ischemic encephalopathy in patients with depression state and their effect on blood rheology

摘要:

目的观察高压氧对因缺血缺氧性脑病所致抑郁状态患者的临床疗效及其对血液流变学的影响。方法将40 例诊断明确的因缺血缺氧性脑病所致抑郁状态入院治疗的患者，按入院先后顺序，采用随机数字表法分为治疗组和等待治疗组（对照组）各20 例。治疗组予高压氧结合常规对症药物处理法治疗，对照组仅予以常规对症药物处理，其中治疗组患者的高压氧治疗隔天1 次，1 周为1 个小疗程，4 个小疗程为1 个总疗程。总疗程前后采用汉密尔顿抑郁量表（HAMD）的减分率评判两组患者的总体临床疗效，简易智能精神状态检查量表（MMSE）评价患者的认知功能，Barthel指数评分评估患者的日常生活能力，同时检测两组患者的血液流变学变化情况。结果两组患者在总疗程治疗后均有效，认知功能、日常生活能力和血液流变学情况与治疗前比较，差异有统计学意义（P <0.05），但治疗组患者总有效率更高，各指标改善较对照组更优。结论应用高压氧结合常规对症药物处理法对缺血缺氧性脑病所致抑郁状态患者的综合临床疗效确切，该法能改善患者的血液流变学指标，促进被受损脑细胞尽可能地恢复，值得临床进一步深入研究并加以推广。

Abstract:

Objective To observe the clinical effect of hyperbaric oxygen therapy on the patients with ischemic encephalopathy induced by ischemia and hypoxia, and to observe the effect of hyperbaric oxygen on hemorheology.Methods Forty cases diagnosed as depression due to ischemic hypoxic encephalopathy were admitted to our hospital. The patients were randomly divided into treatment group and control group according to the order of admission with 20 in each group. The treatment group received hyperbaric oxygen combined with conventional symptomatic drug treatment, the control group received only conventional symptomatic drug treatment. The hyperbaric oxygen treatment was given once every other day, 1 week for a course of treatment, four courses for a total treatment course. Before and after treatment the reduction rate of Hamilton Depression Scale (HAMD) score was used to evaluate the overall clinical efficacy in the two groups, Mini Mental State Examination Scale (MMSE) was used to assess cognitive function and Barthel index score was utilized to estimate the patients' activity of daily living (ADL). Meanwhile hemorheological changes of the two groups were detected. Results In both groups, the treatment methods were effective after the total course of treatment (P < 0.05), the cognitive function, ADL and blood rheology were improved compared with those before treatment (P < 0.05); however, the total effective rate was higher in the treatment group (P < 0.05), and each index was better improved compared with the control group (P < 0.05). Conclusions The application of hyperbaric oxygen combined with conventional symptomatic drug treatment has exact integrated clinical curative effect on depressive state of patients with hypoxic ischemic encephalopathy. This method can significantly improve the hemorheological indexes in the patients, and promote the recovery of damaged brain cells as much as possible. It is worthy of further research and promotion.