摘要目的 探讨高压氧(hyperbaric oxygen,HBO)治疗慢性脑缺血患者的临床疗效及对脑血流灌注的影响.方法 收集2015年7月至2018年7月在烟台山医院神经内科门诊治疗的慢性脑缺血患者120例,按照治疗方法分为对照组和观察组,每组60例.应用欧洲眩晕量表、头昏沉自评量表评定患者眩晕、头昏沉改善程度;应用磁共振(MRI)及3D-动脉自旋标记(arterial spin labeling,ASL)技术评定2组患者治疗前后脑血管灌注水平的变化.结果 治疗8周后,2组患者欧洲眩晕量表评分与治疗前比较差异有统计学意义(P＜0.01),且观察组患者评分[(2.2±0.7)分]明显低于对照组[(3.0±1.0)分],差异有统计学意义(P＜0.05).治疗4～8周后,观察组患者头昏沉自评量表评分明显低于对照组,差异有统计学意义(P＜0.05).治疗8周后,2组患者患侧脑前分水岭白质、中动脉区白质和后分水岭区白质脑血流r-CBF值较治疗前均明显增加,差异有统计学意义(P＜0.01),且观察组治疗后r-CBF值明显高于对照组,差异有统计学意义(P＜0.05).结论 HBO治疗能改善慢性脑缺血临床症状,提高脑血流灌注,值得临床进一步推广应用.

abstractsObjective To investigate the clinical effects of hyperbaric oxygen (HBO) on chronic cerebral ischemia and its impact on cerebral blood perfusion.Methods One hundred and twenty cases of chronic cerebral ischemia that received treatment in Yantaishan Hospital from July 2015 to July 2018 were enrolled for the study,and in accordance with different treatment methods,they were divided into the control group and the observation group,each consisting of 60 cases.Symptom improvement in vertigo and dizziness was assessed by Eurovertigo Scale and Self-rating Dizziness Scale,and changes in cerebral vascular perfusion were detected by magnetic resonance imaging (MRI) and 3-dimensional arterial spin labeling (ASL) before and after treatment.Results After 8 weeks of treatment,the scores of Eurovertigo Scale in the 2 groups were significantly decreased as compared with those before treatment,and statistical significance could be seen when comparisons were made between the 2 groups (P ＜ 0.01).The scores of Eurovertigo Scale in the observation group (2.2 ±:0.7) were significantly lower than those in the control group (3.0 ± 1.0),with statistical significance (P ＜ 0.05).After 4 to 8 weeks of treatment,the scores of Self-rating scale in the observation group were significantly lower than those in the control group,also with statistical significance (P ＜ 0.05).After 8 weeks of treatment,the r-CBF values of cerebral blood flow in white matter of anterior cerebral watershed,white matter of middle artery and white matter of posterior watershed in both groups were significantly increased as compared with those before treatment,also with statistical significance (P ＜0.01),The r-CBF values in the observation group were significantly higher than those in the control group,and statistical significance could also be noted when comparisons were made between the 2 groups (P ＜ 0.05).Conclusion Comprehensive HBO therapy could improve clinical symptoms of chronic cerebral ischemia and cerebral blood perfusion.For this reason,it was worth further clinical application.