早期高压氧治疗对急性脑出血患者脑水肿和氧化应激产物水平的影响

发布时间：2018-10-14 20:04

【摘要】：目的探讨早期高压氧(HBO)治疗对急性脑出血患者脑水肿和氧化应激产物水平的影响。方法选取2015年1~12月该院收治的84例急性脑出血患者作为研究对象,根据抽签法将患者分为观察组(n=42)和对照组(n=42),两组患者均给予常规性护理,对照组在常规性护理基础上应用依达拉奉静脉滴注治疗,观察组在对照组基础上应用HBO治疗,氧压力为0.20~0.25 Mpa,治疗时间为10d,对比分析两组患者治疗前、后应用弥散加权成像测定两组血肿周围水肿区域表现扩散系数(ADC),以了解患者脑水肿程度。应用硫代巴比妥酸法、黄嘌呤氧化酶法及硝酸还原酶法测定两组丙二醛(MDA)、氧化应激产物超氧歧化酶(SOD)和一氧化氮(NO)水平。结果观察组总有效率为92.86%,对照组总有效率为71.43%,两组总有效率差异有统计学意义(P0.05)。观察组治疗后1、3、4周时日常生活能力评分高于对照组,差异有统计学意义(P0.05)。观察组治疗后血肿体积、绝对水肿体积、相对血肿体积、ADC值均少于对照组,差异均有统计学意义(P0.05)。观察组患者治疗后NO、SOD水平显著高于对照组,差异有统计学意义(P0.05),而MDA水平低于对照组,差异也有统计学意义(P0.05)。结论 HBO联合依达拉奉静脉滴注治疗急性脑出血患者能有效减轻脑水肿症状及氧化应激反应,提高患者治疗效果,改善患者日常生活能力,有利于患者预后。
[Abstract]:Objective to investigate the effects of early hyperbaric oxygen (HBO) therapy on cerebral edema and oxidative stress products in patients with acute cerebral hemorrhage. Methods Eighty-four patients with acute intracerebral hemorrhage admitted in our hospital from January to December 2015 were selected as study objects. According to the drawing of lots, the patients were divided into two groups: observation group (n = 42) and control group (n = 42). The patients in both groups were given routine nursing care. The control group was treated with Edaravone intravenous drip on the basis of routine nursing, the observation group was treated with HBO on the basis of the control group, and the oxygen pressure was 0.20 ~ 0.25 Mpa, for 10 days. Diffusion coefficient (ADC),) of edema area around hematoma was measured by diffusion weighted imaging in order to understand the degree of cerebral edema. The levels of superoxide dismutase (SOD) and nitric oxide (NO) were determined by thiobarbituric acid method, xanthine oxidase method and nitrate reductase method. Results the total effective rate was 92.86 in the observation group and 71.43 in the control group. The difference between the two groups was statistically significant (P0.05). The scores of ADL in the observation group were significantly higher than those in the control group at 4 weeks after treatment (P0.05). The hematoma volume, absolute edema volume, relative hematoma volume, ADC value in the observation group were lower than those in the control group after treatment, the difference was statistically significant (P0.05). The level of NO,SOD in the observation group was significantly higher than that in the control group after treatment, the difference was statistically significant (P0.05), while the level of MDA was lower than that in the control group (P0.05). Conclusion HBO combined with Edaravone intravenously in the treatment of acute intracerebral hemorrhage can effectively alleviate the symptoms of cerebral edema and oxidative stress reaction, improve the therapeutic effect, improve the ability of daily life of patients, and benefit the prognosis of the patients.
【作者单位】：江苏省无锡市第三人民医院急诊科;
【分类号】：R743.34;R742

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