McCormick J G, Houle T T, Saltzman H A, Whaley R C, Roy R C
Dept. of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Undersea Hyperb Med. 2011 Sep-Oct;38(5):321-34.
We conducted a retrospective statistical analysis of the Heyman, Saltzman, Whalen 1966 study of 22 stroke patients treated with hyperbaric oxygen (HBO2)--13 of them one to five hours post-stroke. We examined patients who received HBO2 treatment within seven hours post-stroke. An exploratory logistic regression analysis examining the influence of time post-stroke, time in chamber and dose of HBO2, range 2.02 atmospheres absolute (ATA) to 3.04 ATA, was conducted. Only time post-stroke was a significant influence for recovery, with each passing hour decreasing the chance of at least partial transient recovery by 62% - odds ratio: 0.38 (95% CI: 0.15 -0.95), p = 0.039. In the one- to five-hour group of 13 patients, nine (41% of 22) had recovery or recovery with relapse. This represented 69% (+/- 25% SE) of this time frame. Only two of the nine had permanent recovery. Past six hours poststroke, only one patient (11% +/- 21% SE) had partial recovery with relapse. The other eight past six hours had no recovery at all. The first three hours post-stroke HBO2 administration has the most promise for efficacy and improvement of rtPA therapy. HBO2 may also prove to be a useful challenge pre-rtPA administration to assess the risk-benefit ratio for giving rtPA.
我们对海曼、萨尔茨曼、惠伦1966年对22名接受高压氧（HBO₂）治疗的中风患者的研究进行了回顾性统计分析，其中13名患者在中风后1至5小时接受治疗。我们研究了在中风后7小时内接受HBO₂治疗的患者。进行了一项探索性逻辑回归分析，研究中风后时间、舱内时间和HBO₂剂量（范围为2.02绝对大气压（ATA）至3.04 ATA）的影响。只有中风后时间对恢复有显著影响，每过一小时，至少部分短暂恢复的几率降低62%，优势比为0.38（95%置信区间：0.15 - 0.95），p = 0.039。在13名患者的1至5小时组中，9名（占22名的41%）有恢复或恢复后复发。这占该时间段的69%（±25%标准误）。9名患者中只有2名有永久性恢复。中风后6小时后，只有1名患者（11%±21%标准误）有部分恢复并复发。6小时后的其他8名患者完全没有恢复。中风后HBO₂给药的前三个小时对rtPA治疗的疗效和改善最有前景。HBO₂也可能被证明是在rtPA给药前进行有用的挑战，以评估给予rtPA的风险效益比。
