切换至 "中华医学电子期刊资源库"

中华神经创伤外科电子杂志 ›› 2018, Vol. 04 ›› Issue (01) : 29 -32. doi: 10.3877/cma.j.issn.2095-9141.2018.01.008

所属专题: 文献

临床研究

高压氧早期治疗对高血压脑出血患者术后神经功能及血清hs-CRP的影响
邵俊卿1,(), 陈小飞1, 李艺1, 莫俊霖1, 林顺江2   
  1. 1. 523520 东莞市桥头医院重症医学科
    2. 523520 东莞市桥头医院神经外科
  • 收稿日期:2017-07-28 出版日期:2018-02-15
  • 通信作者: 邵俊卿

Effect of hyperbaric oxygen treatment on neurological function and serum hs-CRP in patients with hypertensive intracerebral hemorrhage

Junqing Shao1,(), Xiaofei Chen1, Yi Li1, Junlin Mo1, Shunjiang Lin2   

  1. 1. Intensive Care Unit, Qiao Tou Hospital of Dongguan, Dongguan 523520, China
    2. Department of Neurosurgery, Qiao Tou Hospital of Dongguan, Dongguan 523520, China
  • Received:2017-07-28 Published:2018-02-15
  • Corresponding author: Junqing Shao
  • About author:
    Corresponding author: Shao Junqing, Email:
引用本文:

邵俊卿, 陈小飞, 李艺, 莫俊霖, 林顺江. 高压氧早期治疗对高血压脑出血患者术后神经功能及血清hs-CRP的影响[J/OL]. 中华神经创伤外科电子杂志, 2018, 04(01): 29-32.

Junqing Shao, Xiaofei Chen, Yi Li, Junlin Mo, Shunjiang Lin. Effect of hyperbaric oxygen treatment on neurological function and serum hs-CRP in patients with hypertensive intracerebral hemorrhage[J/OL]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2018, 04(01): 29-32.

目的

探讨高压氧早期治疗对高血压脑出血(HICH)患者术后神经功能恢复及血清hs-CRP水平的影响。

方法

将78例高血压性脑出血患者随机分为高压氧组(42例)和对照组(36例)。对照组给予开颅血肿清除手术、控制血压、脱水降颅压和营养神经等常规治疗,高压氧组在对照组的基础上于术后第5天开始高压氧治疗,每天1次,共20 d。观察2组患者的治疗有效率和入院时、手术后第5天及高压氧20 d后脑水肿程度、血清hs-CRP水平及两者之间的相关性。

结果

高压氧组患者治疗后治疗有效率较对照组明显提高,差异具有统计学意义(P<0.05);治疗后高压氧组和对照组脑水肿体积和血清hs-CRP水平均较治疗前明显降低,差异具有统计学意义(P<0.05),而高压氧组脑水肿体积和血清hs-CRP减少程度显著高于对照组,差异具有统计学意义(P<0.05);Pearson相关分析显示HICH患者血清hs-CRP水平与脑水肿程度之间呈显著正相关关系(P<0.05)。

结论

高压氧早期治疗能显著促进高血压性脑出血患者神经功能的恢复,减轻患者脑水肿程度及降低血清hs-CRP水平。

Objective

To observe the effect of hyperbaric oxygen (HBO) treatment applied to patients with hypertensive intracerebral hemorrhage (HICH) on neurological function and serum hypersensitive C-reactive protein (hs-CRP).

Methods

Seventy-eight patients with HICH were randomly divided into hyperbaric oxygen (HBO) treatment group (n=42) and routine treatment (control) group (n=36). The control group was treated with conventional treatment, including craniotomy, blood pressure control, dehydration to reduce intracranial pressure and nerves nutrition. On the basis of control group, the HBO treatment group was treated with HBO therapy at the fifth day after craniotomy and lasted 20 d. The curative effects and serum hs-CRP were compared between the HBO therapy and control groups before and after treatment.

Results

After treatment, the curative effects were significantly higher in HBO treatment group than those in the control group (P<0.05). As compared with that before treatment, cerebral edema volume and serum hs-CRP level were obviously reduced after treatment (P<0.05) both in HBO treatment group and control group. And there were statistically significant difference in HBO treatment group and control group after treatment. Additionally, there were significant positive correlation between cerebral edema volume and serum hs-CRP levels (P<0.05).

Conclusion

Early treatment with hyperbaric oxygen can significantly promote the recovery of neurological function, alleviate the degree of cerebral edema and reduce the level of serum hs-CRP in patients with HICH.

表1 高压氧组和对照组患者临床疗效的比较
表2 高压氧组和对照组患者脑水肿体积的比较
表3 高压氧组和对照组患者脑水肿体积的比较
图1 高血压脑出血患者脑水肿体积与血清hs-CRP的散点图
[1]
Dowlatshahi D,Brouwers HB,Demchuk AM, et al. Predicting Intracerebral hemorrhage growth with the spot sign: the effect of onset-to-scan time. Stroke, 2016, 47(3): 695-700.
[2]
Lei C,Wu B,Liu M, et al. Pathogenesis and Subtype of Intracerebral Hemorrhage(ICH) and ICH Score Determines Prognosis[J]. Curr Neurovasc Res, 2016, 13(3): 244-248.
[3]
Han D,Li S,Xiong Q, et al. Effect of propofol on the expression of MMP-9 and its relevant inflammatory factors in brain of rat with intracerebral hemorrhage. Cell Biochem Biophys, 2015, 72(3): 675-679.
[4]
Duan X,Wen Z,Shen H, et al. Intracerebral Hemorrhage, Oxidative Stress, and Antioxidant Therapy[J]. Oxid Med Cell Longev, 2016, 2016: 1203285.
[5]
Chen S,Yang Q,Chen G, et al. An update on inflammation in the acute phase of intracerebral hemorrhage[J]. Transl Stroke Res, 2015, 6(1): 4-8.
[6]
Lopresti AL,Maker GL,Hood SD, et al. A review of peripheral biomarkers in major depression: The potential of inflammatory and oxidative stress biomarkers[J]. Prog Neuropsychopharmacol Biol Psychiatry, 2014, 48: 102-111.
[7]
Chang YH,Hwang SK. Frameless stereotactic aspiration for spontaneous intracerebral hemorrhage and subsequent fibrinolysis using urokinase[J]. J Cerebrovasc Endovasc Neurosurg, 2014, 16(1): 5-10.
[8]
Kuo LT,Chen CM,Li CH, et al. Early endoscope-assisted hematoma evacuation in patients with supratentorial intracerebral hemorrhage: case selection, surgical technique, and long-term results[J]. Neurosurg Focus, 2011, 30(4): E9.
[9]
龚燕梅,刘文斌,孙晓萍,等.高压氧对急性脑出血患者脑源性神经营养因子及脑水肿和神经功能的影响[J].中风与神经疾病, 2015, 32(1): 60-63.
[10]
史楠,余波,许玉芳,等.高压氧治疗对老年脑出血患者脑水肿及血浆脑钠肽、脑脊液乳酸浓度的影响[J].中国老年学, 2014, 11(14): 3867-3869.
[11]
王亮,张建富,刘海珠.高压氧对高血压脑出血患者血浆凝血酶水平的影响[J].中华物理医学与康复杂志, 2013, 35(1): 51-52.
[12]
符黄德,黄海能,邓元央,等.老年高血压急性脑出血患者炎症因子水平与周围脑组织水肿的相关性[J].中国老年学杂志, 2017, 37(12): 2924-2926.
[13]
张锋利,洪芳,张向东.老年高血压脑出血患者早期应用血栓通注射液对超敏C反应蛋白及肿瘤坏死因子-α的影响[J].中国老年学杂志, 2016, 36(19): 4747-4749.
[14]
Kitagawa K. Cerebral vessel disease and inflammatory process[J]. Brain Nerve, 2009, 61(9): 1061-1068.
[15]
曾静波,王鹏,高学军,等.银杏内酯注射液辅助治疗高血压脑出血疗效及对神经功能恢复的影响[J].中药药理与临床, 2016, 32(6): 217-220.
[1] 刘立, 陈诚, 李新科, 刘凯, 屠昌明. 血清IL-6、hs-CRP、MMP-9联合检测在腹股沟疝无张力修补术预后评价中的价值分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2023, 17(04): 405-409.
[2] 李海明, 刘鸿飞, 李俊. 血清脂蛋白酶水平与COPD患者骨骼肌质量减少的关系[J/OL]. 中华肺部疾病杂志(电子版), 2023, 16(04): 500-503.
[3] 芦丹, 杨硕, 刘旭. VEGF、HMGB1、hs-CRP/Alb在AECOPD伴呼吸衰竭中的变化及预后分析[J/OL]. 中华肺部疾病杂志(电子版), 2023, 16(04): 532-534.
[4] 王刚, 单伟根, 刘娟, 李长庆, 王新民. 常规治疗联合阿托伐他丁钙片对支气管扩张症临床分析[J/OL]. 中华肺部疾病杂志(电子版), 2023, 16(04): 538-540.
[5] 崔立慧, 李士荣, 李素娟, 孙娴静, 张馨怡. 糖尿病患者肺部感染超敏C反应蛋白和降钙素原检测的临床意义[J/OL]. 中华肺部疾病杂志(电子版), 2023, 16(01): 95-97.
[6] 赵海林, 王璐璐, 罗冬冬, 胡骕, 李丹, 彭彪. 脑室-腹腔分流术对脑膜转移癌的治疗效果分析[J/OL]. 中华神经创伤外科电子杂志, 2022, 08(06): 335-340.
[7] 景方坤, 周建波, 王全才, 黄海韬, 李岩峰, 徐杨熙. 神经导航引导下治疗基底节高血压脑出血的短期疗效预测[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(03): 154-159.
[8] 胡贤瑞, 伍振国, 何竟. 高压氧治疗创伤性脑损伤患者认知功能障碍疗效的Meta分析[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(01): 21-36.
[9] 邸志娟, 李红玲. HBOT在创伤性脑损伤患者中的应用及研究进展[J/OL]. 中华脑科疾病与康复杂志(电子版), 2023, 13(06): 373-378.
[10] 祝梅杰, 梁育磊, 梅厚东, 刘克万, 武孝刚. 早期高压氧治疗外伤性脑梗死的临床疗效及安全性分析[J/OL]. 中华脑科疾病与康复杂志(电子版), 2023, 13(02): 97-101.
[11] 袁捷, 乔钰琪, 李彦冬. 二甲双胍、来曲唑联合地屈孕酮治疗多囊卵巢综合征合并不孕症的效果评价[J/OL]. 中华临床医师杂志(电子版), 2024, 18(04): 343-347.
[12] 张振, 谷雪峰. 预后营养指数及心理应激与老年高血压脑出血术后感染的相关性[J/OL]. 中华老年病研究电子杂志, 2023, 10(03): 31-34.
[13] 汪赓, 夏泽锋, 陶凯雄. 代谢手术在非肥胖型2型糖尿病中的治疗效果及研究进展[J/OL]. 中华肥胖与代谢病电子杂志, 2023, 09(03): 155-160.
[14] 王永彬, 贾彦迅, 尹轶广. 神经导航结合3D重建技术引导神经内镜血肿清除术对高血压脑出血患者的影响[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(02): 153-156.
[15] 田桦, 丁芳, 黄晓莉, 张丽君. 脑蛋白水解物对痉挛型脑瘫患儿肌肉痉挛评分、脑血流量及血清IGF-1、MBP、IL-6的影响[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(01): 49-54.
阅读次数
全文


摘要