早期高压氧治疗对急性脑梗死患者血糖、血乳酸和血氧饱和度的影响

摘要

目的：观察分析早期高压氧治疗对急性脑梗死患者血糖、血乳酸和血氧饱和度的影响，正确评估早期高压氧治疗对急性脑梗死的临床疗效。方法选取2011年5月～2013年2月在神经内科住院治疗的84例脑梗死患者，随机将患者分为观察组和对照组，各42例，给予对照组常压下鼻导管吸氧，观察组则在住院后第2天开始实施高压氧治疗，两组患者均在入院时、第2、5、7、9、14天从右侧颈静脉抽取血样0.5 mL，以测定血糖、血乳酸和血氧饱和度。采用美国国立卫生院神经功能缺损评分（NIHSS）评估神经功能。结果两组患者入院时血糖、血乳酸、血氧饱和度和神经功能评分无显著差异（P＞0.05）；治疗5 d后，观察组的血糖、血乳酸水平有所下降，血氧饱和度显著提高，神经功能逐渐恢复，两组比较差异有统计学意义（P＜0.05），第14天后观察组的血糖、血乳酸恢复到正常水平，且神经功能恢复也优于对照组，两组比较差异有统计学意义（P＜0.05）。结论早期高压氧治疗可以改善急性脑梗死患者的脑能量代谢，有效促进患者神经功能恢复。%Objective To observe and analyze the effect of early hyperbaric oxygen treatment on blood glucose, lactic acid and blood oxygen saturation in patients with acute cerebral infarction.Methods 84 cases of patients with acute cerebral infarction selected from May 2011 to February 2013 in department of neurology were randomly divided into observation group and control group, 42 cases in each group. The patients of control group were given the nasal catheter oxygen under atmospheric pressure, and patients of observation group were treated with hyperbaric oxygen therapy on the second day after hospitalization. Patients of two group were drawn 0.5 mL blood samples from the right jugular vein to measure glucose, lactate, and blood oxygen saturation on the first 2,5, 7,9,14 day after hospitalization. Neurological assessment were used to assess the patients’ nerve function.Results Blood glucose/lactic acid/ blood oxygen saturation/ NIHSS score in patients with acute cerebral infarction in two groups had no significant difference with each other(P>0.05). After 5 d treatment, blood glucose/lactic acid in observation group declined significantly, and oxygen saturation improved, nerve function gradually recovered, which were significant different from the indexes in control group(P<0.05). Section 14 d, blood glucose/lactic acid were returned to normal levels, and the patients’ ne urological function in observation group were also better than those patients’ in control group(P<0.05).Conclusion Early hyperbaric oxygen therapy can i mprove brain energy metabolism in patients with acute cerebral infarction, and Effectively promote the recovery of neurological function of patients.