摘要目的 研究不同时间窗内高压氧治疗对急性脑梗死患者预后的影响.方法 选择符合入组条件的急性脑梗死患者,经医院伦理委员会批准,以及患者知情同意并签署知情同意书后,132例患者采用随机数字表法分为3组(每组44例):急性脑梗死发病1～6d高压氧治疗组(A组);发病7～12 d高压氧治疗组(B组);非高压氧治疗组(C组).高压氧治疗组均应用高压氧治疗10d.在治疗前、治疗后10d及30 d采取美国国立卫生研究院卒中量表(NIHSS)和Barthel指数(BI)评定神经功能缺损程度及日常生活活动能力,比较高压氧疗效.结果 A组治疗后10 d[(2.11 ±2.18)分]及30 d[(0.93±1.21)分]的NIHSS评分明显低于B组[(3.43±2.25)分,(1.70±1.21)分]和C组(P＜0.05).A组治疗后10d及30 d的Barthel指数明显高于B组和C组(P＜0.05).B组治疗后10 d及30 d的NIHSS评分明显低于C组(P＜0.05).B组治疗后10 d的Barthel指数明显高于C组(P＜0.05).B组治疗后30 d的Barthel指数虽高于C组,但差异无统计学意义(P＞0.05).结论 急性脑梗死患者发病1 ～6d及7～12 d应用高压氧治疗效果均优于非高压氧治疗组;发病1～6d应用高压氧治疗效果更佳,可明显改善患者预后,提高生活质量,为急性脑梗死患者高压氧治疗有效治疗时间窗.

abstractsObjective To study the effects of different hyperbaric oxygen (HBO) treatment timing on the prognosis of the patients with acute cerebral infarction (ACI).Methods The patients with acute cerebral infarction that were conformed to the inclusion criteria were enrolled for the study,and were randomly divided into 3 groups,each consisting of 44 patients.The patients that received HBO therapy 1 to 6 days after the onset of ACI were designated as group A,the ones that were treated with HBO therapy 7 to 12 days after the onset of ACI were designated as group B,and the ones that didn 1 receive any HBO therapy were designated as group C.The patients in group A and B all received HBO therapy one session a day for a succession of 10 days.Both before and 10 days after treatment and 1 month after treatment,neural function defect and capacity of daily life activity were assessed by using National Institutes of Health Stroke Scale (NIHSS) and Barthel Index (BI).Therapeutic effects of HBO were compared between the groups.Results The NIHSS scores in group A [(2.11 ± 2.18) score,(0.93 ± 1.21) score] were significantly lower than those in group B [(3.43 ± 2.25) score,(1.70 ± 1.21) score] and group C [(4.68 ± 2.96) score,(2.55 ± 1.69) score],10 days and one month after treatment (P ＜ 0.05).The BI scores in group A were significantly higher than those in group B and group C,10 days and one month after treatment (P＜0.05).The NIHSS scores in group B 10 days and one month after treatment were significantly lower than those in group C (P ＜ 0.05).The BI scores in group B 10 days after treatment were significantly higher than those in group C (P ＜0.05).The BI scores in group B one month after treatment were higher than those in group C,but there was no significant difference,when comparisons were made between the 2 groups (P ＞ 0.05).Conclusions The therapeutic effects of HBO treatment 1 to 6 days and 7 to 12 days after the onset of ACI were all superior to that of the non-HBO group.However,the therapeutic effects of HBO treatment 1 to 6 days after the onset of ACI were obviously better.It could considerably improve the prognosis and life quality of the ACI patients.One to 6 days after onset is the effective HBO treatment time window for ACI.