高压氧中颈段脊髓损伤患者血压和心率的波动及其相关因素

摘要

目的 探讨高压氧治疗对成人颈段脊髓损伤患者血压和心率的影响及其相关因素.方法 选择2015年5月至2017年10月在本科治疗的成人颈段脊髓损伤患者101例为观察组,依据ASIA评分,再分为4组(A~D级).同时选择同舱治疗的突发性耳聋(非脊髓损伤)患者101例作为对照组,依据性别和年龄匹配将对照组再分为4组(A~D组),分别对应观察组A~D级.分别于入舱前、加压末、吸氧30 min、减压前、减压末测量两组患者血压和心率.将匹配各组血压、心率进行比较.并对观察组的血压、心率波动与年龄、病程及ASIA评分的关系进行相关分析和回归分析.结果 观察组A~C级在高压氧治疗期间血压波动明显(P<0.05),观察组D级的血压变化与对照组D组间无显著性差异(P>0.05).ASIA下肢运动评分与血压波动呈负相关(P<0.05).结论 AIS A~C级颈段脊髓损伤患者在高压氧治疗期间血压波动明显,应予以重视.ASIA评分中下肢运动评分是影响血压的独立因素,下肢运动评分越高,血压波动越小.%Objective To investigate the influence of hyperbaric oxygen (HBO) on blood pressure and heart rate in adult patients with cervical spinal cord injury (SCI) and its related factors. Methods From May 2015 to October 2017, 101 cases of adult cervical spinal cord injury in our department were select-ed as observation group, who were divided into four subgroups (AIS A~D) respectively, according to the ASIA score. Other 101 cases of sudden hearing loss without spinal cord injury were selected as control group, who were divided into four subgroups with gender and age matched with four subgroups of the observation group, re-spectively. Blood pressure and heart rate were measured before the compression, at the end of the compression, 30 minutes after oxygen taken in, before the decompression and at the end of the decompression; and were com-pared between groups. The fluctuations of blood pressure and heart rate were correlated and regression analyzed with age, course and AISA score respectively. Results In ASI A~C, the blood pressure fluctuated obviously during the course of hyperbaric oxygen therapy in the ob-servation group (P<0.05). There was no significant difference in blood pressure between ASI D of the observa-tion group and their controls (P>0.05). Lower extremity motor score of ASIA was correlated with the fluctuation of blood pressure (P<0.05). Conclusion The blood pressure fluctuates in patients with cervical spinal cord injury (AIS A~C) during hyperbaric oxy-gen, which should be paid attention to. Lower extremity motor score of ASIA is an independent factor affecting blood pressure. The higher the lower extremity motor score, the smaller the blood pressure fluctuation.