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目的分析对急性脑梗死(ACI)患者在不同时间窗给予不同疗程高压氧治疗的临床疗效。方法 210例新发ACI患者进行观察,所有患者均给予常规对症治疗,根据高压氧不同治疗时间窗及疗程分为1组、2组、3组、4组、5组、6组、7组,每组30例。7组采用神经内科常规治疗。其余组在7组的基础上给予相应治疗,1组在发病12 h内给予高压氧连续治疗20 d,2组在发病12 h内给予高压氧连续治疗40 d,3组在发病12 h~7 d内给予高压氧连续治疗20 d,4组在发病12 h~7 d内给予高压氧连续治疗40 d,5组在发病7 d后给予高压氧连续治疗20 d,6组在发病7 d后给予高压氧连续治疗40 d。比较各组治疗后的神经功能损伤程度、日常生活能力及脑损伤程度。结果各组患者在治疗期间均未出现氧中毒、气压伤等不良反应,所有患者对高压氧的耐受性较好。治疗后,日常生活能力评分(ADL):2组>1组>4组>3组>6组>5组>7组;美国国立卫生研究院卒中量表(NIHSS)评分:2组<1组<4组<3组<6组<5组<7组;脑损伤程度由轻到重依次为:2组、1组、4组、3组、6组、5组、7组;七组NIHSS评分、ADL评分及脑损伤程度比较差异均具有统计学意义(P<0.05)。结论对ACI患者给予高压氧的治疗效果优于常规神经内科治疗效果,且在发病时间12 h内连续进行40 d高压氧治疗的疗效最佳。
Objective To analyze the clinical efficacy of hyperbaric oxygen therapy in patients with acute cerebral infarction (ACI) at different time windows. Methods A total of 210 patients with newly diagnosed ACI were enrolled in this study. All patients were given conventional symptomatic treatment. According to hyperbaric oxygen treatment time window and course of treatment, they were divided into 1 group, 2 groups, 3 groups, 4 groups, 5 groups, 6 groups, 7 groups, 30 cases in each group. 7 groups were treated by routine neurology. The other groups were treated on the basis of 7 groups. One group was treated with hyperbaric oxygen for 20 days within 12 hours of onset, the other two groups were treated with hyperbaric oxygen for 40 days within 12 hours of onset, Continuous hyperbaric oxygen treatment was given for 20 days in each group. Continuous hyperbaric oxygen therapy was given for 40 days in the four groups within 12 hours to 7 days of onset. Continuous hyperbaric oxygen therapy was given in the 5 groups for 20 days after onset for 7 days. In the 6th group, Continuous hyperbaric oxygen therapy was given for 40 days. The degree of neurological injury, daily living ability and brain injury after treatment were compared between groups. Results All the patients had no adverse reactions such as oxygen poisoning and barotrauma during the treatment period, and all patients were well tolerated by hyperbaric oxygen. After treatment, ADLs were as follows: 2 groups> 1 group> 4 groups> 3 groups> 6 groups> 5 groups> 7 groups; NIH Stroke Scale (NIHSS) score: 2 groups <1 group <4 groups <3 groups <6 groups <5 groups <7 groups. The degree of brain injury ranged from light to heavy as follows: group 2, group 1, group 4, group 3, group 6, group 5 and group 7; There was significant difference between the scores of ADL and the degree of brain injury (P <0.05). Conclusions Hyperbaric oxygen therapy is superior to conventional neurology in patients with ACI, and the optimal effect of continuous hyperbaric oxygen therapy for 40 days within the onset time of 12 h is the best.