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高压氧治疗意识障碍的疗效分析:一项回顾性队列研究。

Analysis of the efficacy of hyperbaric oxygen therapy for disorders of consciousness: A retrospective cohort study.

机构信息

Department of Rehabilitation, The Second Hospital of Hebei Medical University, Shijiazhuang, China.

Department of Endocrinology, The Second Hospital of Hebei Medical University, Shijiazhuang, China.

出版信息

Brain Behav. 2024 Jul;14(7):e3588. doi: 10.1002/brb3.3588.

Abstract

OBJECTIVE

To analyze the efficacy and associated factors affecting the prognosis in patients with disturbance of consciousness after hyperbaric oxygen (HBO) treatment.

METHODS

A retrospective study was carried out on patients with disorders of consciousness (DOC) receiving HBO treatment from January to January 2022 in the Second Department of Rehabilitation Medicine of the Second Hospital of Hebei Medical University, China.

RESULTS

HBO therapy improved the Glasgow Coma Scale (GCS) and Chinese Nanjing Persistent Vegetative State Scale (CNPVSS), as well as the clinical efficacy in patients with DOC. The comparison of GCS and CNPVSS scores in patients with DOC before and after HBO treatment was all statistically significant, with 325 patients (67.1%) showing effective results and 159 patients (32.9%) having unchanged outcomes. Univariate analysis indicated that there were statistically significant differences in age, HBO intervention time, HBO treatment times, pre-treatment GCS score, and etiology and underlying diseases between the good and poor prognoses groups. Multivariate regression analysis showed that HBO intervention time ≤7 days, HBO treatment > times, high GCS score before HBO treatment, and brain trauma were independent influencing factors in achieving a good prognosis for patients with DOC. Low pre-treatment GCS scores were an independent risk factor for a poor prognosis in patients with brain trauma while being male, late HBO intervention time, fewer HBO treatment times, and low pre-treatment GCS scores were independent risk factors for a poor prognosis in patients with DOC after a stroke. Being ≥50 years of age, late HBO intervention time, and low pre-treatment GCS scores were independent risk factors for a poor prognosis in patients with DOC after hypoxic-ischaemic encephalopathy.

CONCLUSION

HBO therapy can improve the GCS, CNPVSS scores and clinical efficacy in patients with DOC, and the timing of HBO intervention ≤7 days, times of HBO treatment, high pre-treatment GCS score, and brain trauma were the independent influencing factors of good prognosis in patients with DOC.

摘要

目的

分析高压氧(HBO)治疗后意识障碍患者的疗效及影响预后的相关因素。

方法

对 2022 年 1 月至 1 月在河北医科大学第二医院康复医学二科接受 HBO 治疗的意识障碍(DOC)患者进行回顾性研究。

结果

HBO 治疗可改善 DOC 患者的格拉斯哥昏迷量表(GCS)和中国南京持续性植物状态量表(CNPVSS)评分及临床疗效,DOC 患者 HBO 治疗前后 GCS 和 CNPVSS 评分比较均有统计学意义,有效 325 例(67.1%),无变化 159 例(32.9%)。单因素分析显示,两组在年龄、HBO 干预时间、HBO 治疗次数、治疗前 GCS 评分、病因及基础疾病方面比较,差异均有统计学意义。多因素回归分析显示,HBO 干预时间≤7d、HBO 治疗次数>次、治疗前 GCS 评分高、脑外伤是 DOC 患者预后良好的独立影响因素;治疗前 GCS 评分低是脑外伤患者预后不良的独立危险因素,而男性、HBO 干预时间晚、HBO 治疗次数少、治疗前 GCS 评分低是脑卒中后 DOC 患者预后不良的独立危险因素;年龄≥50 岁、HBO 干预时间晚、治疗前 GCS 评分低是缺氧缺血性脑病后 DOC 患者预后不良的独立危险因素。

结论

HBO 治疗可改善 DOC 患者的 GCS、CNPVSS 评分及临床疗效,HBO 干预时间≤7d、HBO 治疗次数、治疗前 GCS 评分高、脑外伤是影响 DOC 患者预后的独立影响因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3982/11214873/18e73bd47df6/BRB3-14-e3588-g001.jpg

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