摘要目的:探讨高压氧(HBO)治疗脑梗死患者介入时机的选择及对中远期预后的影响。方法:选取2016年9月至2019年7月齐齐哈尔医学院附属第三医院48例行HBO治疗的脑梗死患者归为观察组，同期纳入未采用HBO治疗的48例脑梗死患者为对照组；将HBO介入治疗≤7 d的患者为早期组，>7 d为晚期组。记录患者治疗前后脑血流指标、神经功能缺损评分(NIHSS)、3个月后预后良好率；并分析影响脑梗死患者预后的危险因素。结果:治疗3个疗程后，观察组患者脑前、后、中动脉血流速度高于对照组，阻力指数低于对照组，NIHSS分值低于对照组( P<0.05)；早期组患者脑前、后、中动脉血流速度高于晚期组，阻力指数低于晚期组，NIHSS分值低于晚期组( P<0.05)。观察组预后良好率(77.08%)明显高于对照组(54.17%)，早期组预后良好率(86.96%)明显高于晚期组(68.00%)，差异均有统计学意义( P<0.05)。经单因素分析和进一步Logistic回归分析，确认发病时间、入院NIHSS分值、颅内动脉狭窄和HBO介入时间是影响脑梗死预后的独立因素( P<0.05或 P<0.01)。 结论:早期HBO治疗脑梗死能进一步改善患者脑血流参数，缓解神经功能缺损，对改善中远期预后有明显作用。

abstractsObjective:To analyze the timing of hyperbaric oxygen intervention in cerebral infarction and its impact on medium and long term prognosis.Methods:A total of 48 patients with cerebral infarction who underwent hyperbaric oxygen (HBO) therapy in the Third Affiliated Hospital of Qiqihar Medical University from the September of 2016 to the July of 2019 were included in the observation group. Another 48 patients with cerebral infarction who were not treated with HBO were included in the control group. Patients who received HBO≤7 d were included into the early HBO group, and those who received HBO>7 d were included into the late HBO group. Cerebral blood flow index and neurological deficit score (NIHSS) before and after the treatment as well as the good prognosis rate after 3 months were recorded. The risk factors affecting the prognosis of the patients with cerebral infarction after 3 months were analyzed.Results:After 3 courses of the treatment, the blood flow velocities of the anterior, posterior, and middle arteries of the observation group were higher than those of the control group; the resistance indexes were lower than those of the control group, and the NIHSS score was lower than that of the control group ( P<0.05). The blood flow velocities of the anterior, posterior, and middle arteries in the early HBO group were higher than those in the late HBO group; the resistance indexes of the early HBO group were lower than those of the late HBO group; and the NIHSS score of the early HBO group was lower than that of the late HBO group ( P<0.05). The prognosis of the observation group (77.08%) was significantly higher than that of the control group (54.17%); the prognosis of the early HBO group (86.96%) was significantly higher than that of the control group (68.00%). All the differences were statistically significant ( P<0.05). By unifactorial analysis and further Logistic regression analysis, it was confirmed that onset time, NIHSS score on admission, intracranial artery stenosis, and HBO intervention timing were the independent factors affecting the prognosis of cerebral infarction at 3 months ( P<0.05 or P<0.01). Conclusion:HBO therapy for cerebral infarction can further improve the cerebral blood flow parameters of patients and alleviate neurological defects, which can significantly improve the medium and long term prognosis.