Stroke Research Group, Keele University, Staffordshire, United Kingdom.
J Stroke Cerebrovasc Dis. 2010 Jan;19(1):29-35. doi: 10.1016/j.jstrokecerebrovasdis.2009.02.008.
Mild hypoxia is common in patients with stroke, and associated with worse long-term outcome. Oxygen supplementation could prevent hypoxia and improve recovery. A previous study of routine oxygen supplementation showed no benefit after acute stroke, but did not report compliance and the effect on oxygenation. The aim of this study was to assess the effect of routine low-flow oxygen supplementation on oxygen saturation (SpO(2)) in patients with acute stroke.
In all, 63 patients with normoxic stroke and no indications for oxygen treatment were randomized to 2 L/min oxygen supplementation via nasal cannulae overnight or to control (room air) within 72 hours of symptom onset. Additional oxygen was given at the discretion of the clinical team, if medically indicated. SpO(2) was assessed from 22:00 to 09:00 by pulse oximetry. Compliance with the trial treatment and sleep status were recorded by nursing staff.
In all, 59 patients were confirmed to have had a stroke and available for overnight monitoring. Six (2 oxygen, 4 control) had no or insufficient oximetry data for analysis. The mean nocturnal SpO(2) was 2.5% higher in the oxygen group (n = 27) than in the control group (n = 26) (P < .001). More patients on oxygen than control subjects had SpO(2) greater than 90% throughout the night (59% v 23%). Patients on oxygen had fewer desaturations than control subjects (oxygen desaturation index 4%, 0.8 v 2.1) (P = .001). Oxygen was found to be in place as prescribed in 71%. Oxygen supplementation was not associated with insomnia or restlessness. No patient in either group was given oxygen for clinical indications.
Nocturnal oxygen supplementation at a rate of 2 L/min increases the mean nocturnal SpO(2) by 2.5% and reduces the number of nocturnal desaturations in patients with acute stroke.
轻度缺氧在脑卒中患者中很常见，且与长期预后较差相关。氧疗可以预防缺氧并促进恢复。既往常规氧疗的研究显示对急性脑卒中无益，但未报告氧疗的依从性及其对氧合的影响。本研究旨在评估常规低流量氧疗对急性脑卒中患者血氧饱和度（SpO2）的影响。
共纳入 63 例无低氧血症且无氧疗指征的急性脑卒中患者，随机分为夜间接受 2 L/min 氧疗（经鼻导管）组或 72 小时内接受室内空气组。若临床需要，可额外给予氧气。通过脉搏血氧仪评估 22:00 至 09:00 的 SpO2。护理人员记录氧疗依从性和睡眠情况。
共 59 例患者符合纳入条件并完成了夜间监测。6 例（2 例氧疗组，4 例对照组）的血氧监测数据不足或不完整，无法进行分析。氧疗组（n=27）的夜间平均 SpO2 比对照组（n=26）高 2.5%（P<0.001）。夜间 SpO2>90%的患者氧疗组（59%）多于对照组（23%）（P<0.001）。氧疗组患者的低氧血症次数较对照组少（氧饱和度下降指数：4% vs 2.1%）（P=0.001）。氧疗组中 71%的患者按规定使用了氧气。氧疗并未导致失眠或不安。两组均未因临床指征给予氧气。
急性脑卒中患者夜间接受 2 L/min 氧疗可使平均夜间 SpO2升高 2.5%，减少夜间低氧血症的发生次数。
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