高压氧治疗脑梗死的远期预后观察
发布时间：2018-12-15 22:24
【摘要】：目的:研究高压氧治疗对脑梗死患者远期不良结局的影响及高压氧治疗的安全性,并对高压氧的可能合适的介入时间进行评估。方法:1、本研究为真实世界前瞻性队列研究,对2013年12月至2016年5月四川省人民医院高压氧科收治的127例在90天内发生缺血性卒中的患者,收集患者基线资料,如姓名、性别、年龄、发病到入院时间、美国国立卫生院脑卒中量表(NIHSS)评分、既往病史、入院后检查结果、出院时诊断、梗死TOAST分型、住院期间治疗及高压氧治疗开始时间、次数、不良反应等。2、在发病后3月、6月进行随访,记录患者出院后的主要治疗情况、卒中复发情况、死亡情况、发病后3月及6月残疾情况(mRS评分≤2分则认为脑卒中患者非残疾,2分则认为患者残疾),将残疾及死亡均作为不良结局。3、使用EXCEL表汇总原始数据,再使用SPSS17.0统计学软件进行统计学计算,符合正态分布的计量资料采用均数±标准差(x±s)表示,不符合正态分布的计量资料采用中位数±四分位数(M±q25~q75)表示,计数资料采用构成比表示。先进行单因素分析筛选出在两结局组中差异较大的影响因素,再根据单因素分析、研究目的及参考文献筛选危险因素纳入logistic回归模型,P0.05为差异有显著性。结果:1、发病后3月共随访到患者119人,多因素回归分析显示入院NIHSS评分高、颅内动脉狭窄是影响预后的独立危险因素,行高压氧治疗对全部急性期及恢复期脑梗死患者预后影响无统计学意义,但早期(发病到高压氧治疗时间≤7天)行高压氧对预后有改善作用。出院后依从性在两次多因素分析中对预后无明显统计学意义但P接近0.05。2、发病后6月共随访到患者117人,结果显示入院NIHSS评分高及出院后依从性差是影响患者6月预后的独立危险因素,高压氧治疗对六月预后影响无明显统计学意义,早期高压氧治疗对发病后6月预后虽然无统计学意义,但P值非常接近0.05(P=0.08)。颅内动脉狭窄在本研究中对6月预后的影响无统计学意义。3、未观察到与高压氧治疗相关的严重不良反应及死亡。高压氧疗程对脑梗死远期预后的影响因样本量较小没有进行多因素分析,高压氧治疗对复发率及死亡率的影响因基线资料不可比仅作了描述性统计。结论:1、脑梗死患者早期(≤7天)行高压氧治疗有改善脑梗死3月结局的作用,对6月结局则存在可能有改善的趋势,高压氧治疗恢复期脑梗死及高压氧的疗程对预后影响则需要进一步研究。2、高压氧对脑梗死的复发率、死亡率可能还需要进一步更大样本量的研究。3、高压氧治疗脑梗死无严重不良反应,高压氧是较安全的治疗。
[Abstract]:Objective: to study the effect of hyperbaric oxygen therapy on long-term adverse outcome and safety of hyperbaric oxygen therapy in patients with cerebral infarction, and to evaluate the possible appropriate intervention time of hyperbaric oxygen. Methods: 1. This study was a real-world prospective cohort study of 127 patients with ischemic stroke in the Department of Hyperbaric oxygen, Sichuan Provincial people's Hospital from December 2013 to May 2016. Baseline data, such as name, were collected. Sex, age, time from onset to admission, (NIHSS) score of stroke scale, past medical history, results of examination after admission, diagnosis at discharge, classification of infarct TOAST, time and frequency of onset of hospitalization and hyperbaric oxygen therapy, Adverse reactions, etc. 2. Follow up 3 months and 6 months after the onset of the disease, record the main treatment, stroke recurrence, death after discharge, 3 and 6 months after the onset of the disease, disability (mRS score 鈮，
本文编号：2381380
[Abstract]:Objective: to study the effect of hyperbaric oxygen therapy on long-term adverse outcome and safety of hyperbaric oxygen therapy in patients with cerebral infarction, and to evaluate the possible appropriate intervention time of hyperbaric oxygen. Methods: 1. This study was a real-world prospective cohort study of 127 patients with ischemic stroke in the Department of Hyperbaric oxygen, Sichuan Provincial people's Hospital from December 2013 to May 2016. Baseline data, such as name, were collected. Sex, age, time from onset to admission, (NIHSS) score of stroke scale, past medical history, results of examination after admission, diagnosis at discharge, classification of infarct TOAST, time and frequency of onset of hospitalization and hyperbaric oxygen therapy, Adverse reactions, etc. 2. Follow up 3 months and 6 months after the onset of the disease, record the main treatment, stroke recurrence, death after discharge, 3 and 6 months after the onset of the disease, disability (mRS score 鈮，
本文编号：2381380
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