Wang Hongyu, Li Changhe, Chen Huimin, Ren Caihong, Liu Yajie, Gao Jiankai, Wang Hong, Li Peiliang, Liu Jinqiang, Li Yujing, Zhang Sisen
The Fifth Clinical Medical College, Henan University of Traditional Chinese Medicine, Zhengzhou 450003, Henan, China.
Department of Emergency Medicine, People's Hospital of Henan University of Traditional Chinese Medicine/Zhengzhou People's Hospital, Zhengzhou 450003, Henan, China.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2024 Dec;36(12):1285-1289. doi: 10.3760/cma.j.cn121430-20231115-00980.
To investigate the effect of hyperbaric oxygen (HBO) on paroxysmal sympathetic hyperexcitation (PSH) after brain injury.
A multicenter retrospective study was conducted. Fifty-six patients with PSH who received HBO treatment from four hospitals in Henan Province from January 2021 to September 2023 were selected as the HBO group, and 36 patients with PSH who did not receive HBO treatment from Zhengzhou People's Hospital from May 2018 to December 2020 were selected as the control group. PSH assessment measure (PSH-AM) score [clinical feature scale (CFS) score+diagnostic likelihood tool (DLT) score] and Glasgow coma scale (GCS) were compared before and after HBO treatment, and between HBO group and control group to evaluate the effect of HBO treatment on prognosis of PSH patients.
There were no statistically significant differences in age, gender, PSH etiology, GCS score, time from onset to occurrence of PSH, CFS score, CFS+DLT score and frequency of PSH episodes between the two groups, indicating comparability. The duration of HBO treatment ranged from 3 to 11 days for 56 patients receiving HBO treatment, and the duration of HBO treatment ranged from 3 to 5 courses. Compared with before treatment, after HBO treatment, PSH symptoms in HBO patients were significantly relieved (body temperature increase: 14.29% vs. 64.29%, heart rate increase: 25.00% vs. 98.21%, shortness of breath: 14.29% vs. 76.79%, blood pressure increase: 8.93% vs. 85.71%, sweating: 10.71% vs. 85.71%, muscle tone increased: 19.64% vs. 75.00%, all P < 0.05), CFS+DLT score decreased significantly (16.90±4.81 vs. 22.12±3.12, P < 0.01), GCS score improved (12.31±5.34 vs. 5.95±2.18, P < 0.01). After 30 days of hospitalization, compared with the control group, PSH symptoms in the HBO group were improved (body temperature increase: 14.29% vs. 19.44%, heart rate increase: 19.64% vs. 25.00%, shortness of breath: 10.71% vs. 27.78%, blood pressure increase: 7.14% vs. 22.22%, sweating: 8.93% vs. 25.00%, muscle tone increased: 19.64% vs. 38.89%, all P < 0.05 except body temperature increase), CFS+DLT score decreased (16.90±3.81 vs. 19.98±4.89, P < 0.05), GCS score increased (14.12±4.12 vs. 12.31±4.14, P < 0.01), the length of intensive care unit (ICU) stay was shortened (days: 18.01±5.67 vs. 24.93±8.33, P < 0.01).
HBO treatment can significantly relieve the symptoms of patients with PSH after brain injury and provide a new idea for the treatment of PSH patients.
探讨高压氧（HBO）对脑损伤后阵发性交感神经过度兴奋（PSH）的影响。
进行一项多中心回顾性研究。选取2021年1月至2023年9月在河南省四家医院接受HBO治疗的56例PSH患者作为HBO组，选取2018年5月至2020年12月在郑州市人民医院未接受HBO治疗的36例PSH患者作为对照组。比较HBO治疗前后以及HBO组与对照组之间的PSH评估量表（PSH-AM）评分[临床特征量表（CFS）评分+诊断可能性工具（DLT）评分]和格拉斯哥昏迷量表（GCS），以评估HBO治疗对PSH患者预后的影响。
两组在年龄、性别、PSH病因、GCS评分、PSH发病时间、CFS评分、CFS+DLT评分及PSH发作频率方面差异均无统计学意义，具有可比性。56例接受HBO治疗的患者，HBO治疗疗程为3至11天，HBO治疗疗程为3至5个疗程。与治疗前相比，HBO治疗后，HBO组患者PSH症状明显缓解（体温升高：14.29%对64.29%，心率加快：25.00%对98.21%，呼吸急促：14.29%对76.79%，血压升高：8.93%对85.71%，出汗：10.71%对85.71%，肌张力增加：19.64%对75.00%，均P<0.05），CFS+DLT评分显著降低（16.90±4.81对22.12±3.12，P<0.01），GCS评分改善（12.31±5.34对5.95±2.18，P<0.01）。住院30天后，与对照组相比，HBO组PSH症状改善（体温升高：14.29%对19.44%，心率加快：19.64%对25.00%，呼吸急促：10.71%对27.78%，血压升高：7.14%对22.22%，出汗：8.93%对25.00%，肌张力增加：19.64%对38.89%，除体温升高外均P<0.05），CFS+DLT评分降低（16.90±3.81对19.98±4.89，P<0.05），GCS评分升高（14.12±4.12对12.31±4.14，P<0.01），重症监护病房（ICU）住院时间缩短（天数：18.01±5.67对24.93±8.33，P<0.01）。
HBO治疗可显著缓解脑损伤后PSH患者的症状，为PSH患者的治疗提供了新思路。
