不同时间窗实施高压氧治疗对急性脑梗死患者NIHSS、ADL评分的影响

目的不同时间窗实施高压氧治疗对急性脑梗死患者NIHSS、ADL评分的影响。方法人选的118例急性脑梗死患者根据从发病到实施高压氧的不同时间随机分为三组，Ⅰ组t〈12h共20例，Ⅱ组t≥12h．且t〈7d共32例；Ⅲ组t≥7d共36例，另选择同期行药物治疗的30例设立为Ⅶ组，为对照组，未予高压氧治疗。比较高压氧辅助治疗的疗效及治疗14d、28d、90d各组NIHSS评分、ADL评分的动态变化。结果四组治疗后有效率比较，差异无统计学意义（P〉0．05），而基本痊愈率比较，差异有统计学意义（P〈0．05），在治疗后第14，28及90天时，I至Ⅳ组患者NIHSS评分较治疗前明显降低，差异存在显著性（P〈0．05）；其中I组NIHSS评分降低程度较其他三组改善最明显（P〈0．05），Ⅱ组NIHSS评分降低程度较Ⅲ组及Ⅳ组显著（P〈0．05），Ⅲ组及Ⅳ组间差异不显著（P〉0．05）。I组、Ⅱ组、Ⅲ组、Ⅳ组四组经高压氧治疗后14d、28d、90dADL评分较治疗前虽然有所增加，但组间比较经统计学处理，差异无显著性（P〉0．05）。且四组ADL评分在治疗后14d及治疗后的28d均随着治疗时间的延长分别较治疗前及前一时间点有所增加，但差异无显著性（P〉0．05）。而治疗后的90d，四组ADL评分分别均较治疗前显著增加，差异有显著性（P〈0．05）。结论对于急性脑梗死患者，采用高压氧治疗越早，越能显著改善患者神经功能缺损程度，提高日常生活活动能力；但本研究由于样本数量偏少、脑梗死类型较单一，尚有待于进一步扩大样本数量进行探讨。

Effects of Different time windows implementation of hyperbaric oxygen therapy on the NIHSS, ADL score in patients with acute cerebral infarction

Objective To expolre the impact on the NIHSS, ADL score of different time windows implementation of hyperbaric oxygen therapy in patients with acute cerebral infarction. Methods All 118 patients patients with acute score in the treatment of hyperbaric oxygen adjuvant therapy in the 14 days, 28 days, 90 days. Results The treatment efficiency had no statistically significant difference between four groups（P 〉 0.05）, the difference of the basic recovery rate was statistically significant （P 〈 0.05）. After treatment 14, 28 and 90 days, the NIHSS scores were significantly lower than before treatment from I group to IV group patients, the difference was significant （P 〈 0.05）; NIHSS score of group I reduced more significant compared with the other three groups （P 〈 0.05）, NIHSS scoreof group I1 reduced more significantly than group m and group IV （P 〈0.05）, the difference was not significant（P 〉 0.05） between group ]]I and group IV. Although the ADL score increaseed than before treatment of four groups by hyperbaric oxygen therapy after treatment 14 days, 28 days, 90 days, but difference was not significant （P 〉 0.05）. And after treatment 14 days and 28 days, the ADL score was increased than before treatment, was increased than a previous time along with the treatment time, but the difference was not significant（P 〉 0.05）. And after treatment 90 days, the ADL scores were compared with pre-treatment significantly increased, the difference was signifieant（P 〈 0.05）. Conclusion The hyper- baric oxygen therapy sooner, they can significantly improve the degree of neurological deficits in patients with activities of daily living of acute cerebral infarction; However, this study due to the number of samples is less than normal, cerebral infarction than a single type, still needs further expand the number of samples to explore.