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。中国。
结果:HBO治疗改善了格拉斯哥昏迷量表(GCS)和中国南京持续植物状态量表(CNPVSS),以及DOC患者的临床疗效。DOC患者HBO治疗前后GCS和CNPVSS评分比较均有统计学意义,其中325例患者(67.1%)显示有效结果,159例患者(32.9%)结果不变。单因素分析显示年龄差异有统计学意义,HBO干预时间,HBO治疗次数,治疗前GCS评分,预后良好和不良组之间的病因和潜在疾病。多因素回归分析显示HBO干预时间≤7天,HBO治疗>次数,HBO治疗前GCS评分高,脑外伤是DOC患者获得良好预后的独立影响因素。治疗前GCS评分低是男性脑外伤患者预后不良的独立危险因素,后期HBO干预时间,HBO治疗次数更少,治疗前GCS评分低是卒中后DOC患者预后不良的独立危险因素。年龄≥50岁,后期HBO干预时间,治疗前GCS评分低是DOC患者缺氧缺血性脑病预后不良的独立危险因素。
结论:HBO治疗可以改善GCS,DOC患者CNPVSS评分与临床疗效,HBO干预时间≤7天,HBO治疗的次数,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。
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.
CONCLUSIONS: 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.