Ni Xiaoxiao, Liu Zhifeng, Xie Qiuyou, Tong Huasheng, Su Lei, Yu Ronghao
Department of Neurological Rehabilitation, Guangzhou General Hospital of Guangzhou Military Region, Guangzhou 510010, Guangdong, China (Ni XX, Xie QY, Yu RH); Department of Critical Care Medicine, Guangzhou General Hospital of Guangzhou Military Region, Guangzhou 510010, Guangdong, China (Liu ZF, Tong HS, Su L). Corresponding author: Su Lei, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2017 Jun;29(6):572-576. doi: 10.3760/cma.j.issn.2095-4352.2017.06.020.
With the global warming, the incidence of heat stroke was significantly higher than before. Severe heat stroke has a high mortality, high morbidity and consolidated central nervous system injury characteristics. The main features of severe heat stroke cerebral injury include cognitive impairment, delirium, convulsions and coma. Its mechanism is related with heat shock induced cerebral tissue ischemia and hypoxia, vascular dysfunction, secondary cascade inflammation and so on. Currently, the main treatment of heat stroke cerebral injury is the hypothermia therapy, dehydration for the reduction of intracranial pressure, naloxone and other cerebral protection and nutrition treatments. Hyperbaric oxygen therapy (HBOT) is effective in treating brain injury. HBOT can alleviate tissue ischemia and hypoxia, improve circulation, reduce cerebral edema, and anti-inflammatory, anti-oxidative damage, anti-apoptosis and other molecular biological effects. HBOT also play a wake up-promoting effect of nerve repair in the cerebral injury. The treatment of cerebral injury has been the difficulty and weakness of heat stroke research. Therefore, this article reviewed the epidemiology, pathogenesis, the therapeutic effect and mechanism of hyperbaric oxygen on cerebral injury in severe heat stroke to clarify the advantages of HBOT and to provide experimental basis for further research.
随着全球气候变暖,中暑的发病率显著高于以往。重症中暑具有高死亡率、高发病率以及中枢神经系统损伤严重的特点。重症中暑脑损伤的主要特征包括认知障碍、谵妄、惊厥和昏迷。其机制与热休克所致脑组织缺血缺氧、血管功能障碍、继发性级联炎症等有关。目前,中暑脑损伤的主要治疗方法是亚低温治疗、脱水降颅压、纳洛酮等脑保护及营养治疗。高压氧治疗(HBOT)对脑损伤治疗有效。HBOT可缓解组织缺血缺氧、改善循环、减轻脑水肿,并具有抗炎、抗氧化损伤、抗凋亡等分子生物学效应。HBOT在脑损伤中还对神经修复起到促醒作用。脑损伤的治疗一直是中暑研究的难点与薄弱环节。因此,本文综述了重症中暑脑损伤的流行病学、发病机制、高压氧治疗的疗效及机制,以阐明HBOT的优势,为进一步研究提供实验依据。