摘要
目的 应用MRI检测观察高压氧(HBO)治疗对急性脑出血灶周围脑水肿的影响.方法 63例幕上脑出血住院患者,随机分为HBO治疗组(n=30,HBO组)和对照组(n=33),2组均给予常规治疗,HBO组于发病后3～5 d开始同时给予HBO治疗,每日1次,连续20 d.病程第5～7天和第25天进行头颅MRI检查,T2WI图像观测脑水肿的范围,计算脑水肿绝对体积和相对体积,弥散加权成像(DWI)测定血肿周围水肿区域表观扩散系数(ADC)值以了解脑水肿的程度.结果 治疗前2组年龄、性别、血压、美国同立卫生研究院卒中量表(NIHSS)、出血部位及血肿体积间差异无统计学意义.病程第5～7天,HBO组的绝对脑水肿体积和相对脑水肿体积均显著小于对照组(P<0.05),到病程第25天,脑水肿仍较明显,HBO组的绝对脑水肿体积、相对脑水肿体积和ADC值均显著小于对照组(P<0.05).结论 早期使用HBO治疗脑出血可以显著减轻脑水肿的程度和范围,脑出血(ICH)后脑水肿持续存在,连续HBO治疗可有效减轻迟发性脑水肿,从而可能有利于患者神经功能的恢复.
Objective To study the effect of hyperbaric oxygen (HBO) therapy on perihematomal edema in acute spontaneous intracerebral hemorrhage. Methods Sixty-three consecutive hospitalized patients with supraten-torial intracerebral hemorrhage were allocated to an HBO group (n = 30) or a control group (n = 33) at random. Routine therapies were used with both groups. The treatment group received in addition twenty consecutive daily ses-sions of HBO therapy beginning 3～5 d after onset. MRI brain scans were performed on the 5～7th and 25th day. Absolute edema volumes and relative edema volumes were measured from T2-weighted images. Apparent diffusion co-efficients (ADCs) of the edematous regions were calculated on diffusion-weighted images (DWI). Results There were no statistical differences between the two groups in terms of age, sex, blood pressure, NIHSS, hematoma posi-tion or volume. At the 5th～7th d, both absolute and relative edema volumes in the HBO group were smaller than in the controls (P≤0.05). Brain edema was still prominent at the 25th d. Absolute edema volumes, relative edema volumes and ADC values were all smaller in the HBO group at the 25th day compared with the controls (P≤0.05). Conclusion HBO therapy soon after intracerebral hemorrhage can lessen the severity and range of brain edema. E-dema persists after the onset of the disease, and HBO can reduce such delayed brain edema. HBO may benefit func-tional recovery from intracerebral hemorrhage by reducing perihematomal edema
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2009年第1期44-46,共3页
Chinese Journal of Physical Medicine and Rehabilitation
基金
南通市社会发展计划项目(S5030)
关键词
高压氧
脑出血
脑水肿
磁共振成像
表观扩散系数
Hyperbaric oxygen
Intracerebral hemorrhage
Brain edema
Magnetic resonance ima-ging
Apparent diffusion coefficients
