Ye Daijun, Ning Cong, Lei Yu, Sun Mingli
Department of Second Emergency Medicine, the First Hospital of Jilin University, Changchun 130000, Jilin, China. Corresponding author: Sun Mingli, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2020 Feb;32(2):215-220. doi: 10.3760/cma.j.cn121430-20200107-00040.
To explore the effect of treatment opportunity and course of hyperbaric oxygen (HBO) on the curative effect of cerebral resuscitation patients after successful cardiopulmonary resuscitation (CPR).
Eighty-nine patients who underwent cerebral resuscitation after CPR admitted to the second department of the First Hospital of Jilin University from June 2015 to June 2019 were enrolled. All patients underwent conventional drug therapy after admission, and HBO therapy was added on the basis of conventional drug therapy at different intervention times, and all patients received at least 3 courses of HBO treatment. Glasgow coma scale (GCS) score and amplitude-integrated electroencephalography (aEEG) score on different treatment opportunity (i.e. intervention of HBO within 12 hours, 12-72 hours, 4-7 days, 8-21 days after successful CPR) and different course of HBO (i.e. 1, 2 and 3 courses of treatment) were recorded. Repeated measurement analysis of variance was used to assess whether the treatment opportunity or course of treatment affects the GCS score and aEEG score. Then, paired sample t test was used to further analyze the results of repeated measurement analysis of variance and evaluate the specific effect of treatment course or intervention time on the efficacy.
A total of 89 patients were enrolled. 8, 20, 33 and 28 patients started HBO treatment at < 12 hours, 12-72 hours, 4-7 days and 8-21 days after successful CPR. (1) GCS score: repeated measurement analysis of variance (the Greenhouse-Geisser correction method was used) showed that the effect of course of HBO treatment on GCS score was statistically significant (F = 71.735, P = 0.000). The interaction between the duration of HBO treatment and the timing of intervention was not statistically significant (F = 0.455, P = 0.817). Paired sample t test showed that the means of GCS scores before HBO treatment and treatment 1, 2, 3 courses were 3.56, 4.80, 5.55 and 6.49 respectively, and the difference of pairwise pairing between different groups were statistically significant (all P < 0.01). (2) aEEG score: repeated measurement analysis of variance (the Greenhouse-Geisser correction method was used) showed that the effect of course of HBO treatment on aEEG score was statistically significant (F = 96.965, P = 0.000).The interaction between the duration of HBO treatment and the timing of intervention was not statistically significant (F = 1.735, P = 0.112). Paired sample t test showed that the means of aEEG scores before HBO treatment and treatment 1, 2, 3 courses were 1.71, 2.21, 2.52 and 3.03 respectively (all P < 0.01).
The effect of HBO on cerebral resuscitation after CPR is obvious. The longer the course of HBO is, the more significant the effect of cerebral resuscitation is. Within 21 days after successful CPR, the treatment opportunity of HBO had no significant effect on the effect of cerebral resuscitation.
探讨高压氧（HBO）治疗时机及疗程对心肺复苏（CPR）成功后脑复苏患者疗效的影响。
选取2015年6月至2019年6月在吉林大学第一医院二部住院的89例CPR成功后脑复苏患者。所有患者入院后均接受常规药物治疗，并在不同干预时间于常规药物治疗基础上加用HBO治疗，所有患者均接受至少3个疗程的HBO治疗。记录不同治疗时机（即CPR成功后12小时内、12 - 72小时、4 - 7天、8 - 21天进行HBO干预）及不同HBO疗程（即1、2、3个疗程治疗）时的格拉斯哥昏迷量表（GCS）评分及振幅整合脑电图（aEEG）评分。采用重复测量方差分析评估治疗时机或疗程是否影响GCS评分及aEEG评分。然后，采用配对样本t检验进一步分析重复测量方差分析结果，评估治疗疗程或干预时间对疗效的具体影响。
共纳入89例患者。8例、20例、33例和28例患者分别在CPR成功后<12小时、12 - 72小时、4 - 7天和8 - 21天开始HBO治疗。（1）GCS评分：重复测量方差分析（采用Greenhouse-Geisser校正法）显示，HBO治疗疗程对GCS评分的影响具有统计学意义（F = 71.735，P = 0.000）。HBO治疗持续时间与干预时机之间的交互作用无统计学意义（F = 0.455，P = 0.817）。配对样本t检验显示，HBO治疗前及治疗1、2、3个疗程时GCS评分的均值分别为3.56、4.80、5.55和6.49，不同组间两两配对差异均具有统计学意义（均P < 0.01）。（2）aEEG评分：重复测量方差分析（采用Greenhouse-Geisser校正法）显示，HBO治疗疗程对aEEG评分的影响具有统计学意义（F = 96.965，P = 0.00）。HBO治疗持续时间与干预时机之间的交互作用无统计学意义（F = 1.735，P = 0.112）。配对样本t检验显示，HBO治疗前及治疗1、2、3个疗程时aEEG评分的均值分别为分别为1.71、2.21、2.52和3.03（均P < 0.01）。
HBO对CPR后脑复苏效果明显。HBO疗程越长，脑复苏效果越显著。CPR成功后21天内，HBO的治疗时机对脑复苏效果无显著影响。
