Zhai Wei-Wei, Sun Liang, Yu Zheng-Quan, Chen Gang
Department of Neurosurgery & Brain and Nerve Research Laboratory, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
Med Gas Res. 2016 Jul 11;6(2):111-118. doi: 10.4103/2045-9912.184721. eCollection 2016 Apr-Jun.
Stroke, which is defined as a neurologic deficit caused by sudden impaired blood supply, has been considered as a common cause of death and disability for decades. The World Health Organization has declared that almost every 5 seconds a new stroke occurs, placing immense socioeconomic burdens. However, the effective and available treatment strategies are still limited. Additionally, the most effective therapy, such as thrombolysis and stenting for ischemic stroke, generally requires a narrow therapeutic time window after the event. A large majority of patients cannot be admitted to hospital and receive these effective treatments for reperfusion timely. Hyperbaric oxygen therapy (HBOT) has been frequently applied and investigated in stroke since 1960s. Numerous basic and clinical studies have shown the beneficial efficacy for neurological outcome after stroke, and meanwhile many underlying mechanisms associated with neuroprotection have been illustrated, such as cerebral oxygenation promotion and metabolic improvement, blood-brain barrier protection, anti-inflammation and cerebral edema, intracranial pressure modulation, decreased oxidative-stress and apoptosis, increased vascular and neural regeneration. However, HBOT in human stroke is still not sufficiently evidence-based, due to the insufficient randomized double-blind controlled clinical studies. To date, there are no uniform criteria for the dose and session duration of HBOT in different strokes. Furthermore, the additional effect of HBOT combined with drugs and other treatment strategies are being investigated recently. Therefore, more experimental and clinical research is imperative to identify the mechanisms more clearly and to explore the best protocol of HBOT in stroke treatment.
中风被定义为由突然的血液供应受损引起的神经功能缺损，几十年来一直被视为死亡和残疾的常见原因。世界卫生组织宣称几乎每5秒钟就有一例新的中风发生，这带来了巨大的社会经济负担。然而，有效的治疗策略仍然有限。此外，最有效的治疗方法，如缺血性中风的溶栓和支架置入术，通常需要在发病后有一个狭窄的治疗时间窗。绝大多数患者无法及时入院并接受这些有效的再灌注治疗。自20世纪60年代以来，高压氧治疗（HBOT）已在中风治疗中得到频繁应用和研究。大量的基础和临床研究表明其对中风后神经功能结局有益，同时也阐明了许多与神经保护相关的潜在机制，如促进脑氧合和改善代谢、保护血脑屏障、抗炎和减轻脑水肿、调节颅内压、减少氧化应激和细胞凋亡、增加血管和神经再生。然而，由于缺乏足够的随机双盲对照临床研究，人类中风中的高压氧治疗仍缺乏充分的循证依据。迄今为止，不同类型中风的高压氧治疗剂量和疗程持续时间尚无统一标准。此外，最近正在研究高压氧治疗与药物及其他治疗策略联合使用的附加效果。因此，迫切需要更多的实验和临床研究来更清楚地确定其机制，并探索中风治疗中高压氧治疗的最佳方案。
