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不同压力高压氧治疗颅脑损伤后失语症的疗效及依从性 被引量:26

Hyperbaric oxygen therapy at different pressure levels for aphasia following craniocerebralinjury: efficacy, safety and patient adherence to therapy
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摘要 目的探讨颅脑损伤后失语症患者给予不同压力高压氧治疗(HBO)的临床疗效及治疗依从性。方法将接受30次HBO治疗的31例颅脑损伤后失语症患者纳入治疗1组;将2009年1月-2011年6月间接受30次HBO治疗的31例颅脑损伤后失语症患者纳入治疗2组;将2009年1月-2013年12月间拒绝HBO治疗的31例颅脑损伤后失语症患者纳入对照组。对照组给予常规的脑外科综合治疗,治疗组在采用综合治疗基础上,治疗1组实施0.175MPa压力HBO治疗,治疗2组实施0.20MPa压力HBO治疗。观察3组治疗前后,采用西方失语症成套测验(westernaphasiabattery,wAB),并对组间WAB各亚项及AQ评分、疗效、失语平均恢复时间、医嘱依从性进行比较。结果对照组有效率(58.06%)显著低于治疗1组(83.87%)和治疗2组(87.1%)。对照组与治疗组WAB各亚项及AQ评分、疗效、失语平均恢复时间比较:差异有统计学意义(P〈0.05);治疗组间比较:差异无统计学意义(P〉0.05)。实施0.175IMPa压力与实施0.20MPa压力HBO治疗患者医嘱依从性比较:医嘱不依从前者比后者例数减少31.37%,医嘱部分依从增加13.86%,医嘱完全依从增加17.51%,两者差异有统计学意义(P〈0.05)。结论HBO治疗颅脑损伤后失语症患者建议采用0.175MPa的治疗压力。可以确保安全、有效,并能增强患者医嘱依从性。 Objective To observe the clinical effect of hyperbaric oxygen (HBO) therapy at different pressure levels on aphasia after craniocerebral injury and assess the patient adherence to the therapies. Methods Thirty-one patients with aphasia after craniocerebral injury receiving 30 sessions of HBO therapy at the pressure level of 0.175 MPa and another 31 patients receiving 0.2 MPa therapy were recruited as the treatment groups 1 and 2, respectively; 31 patients who refused to have HBO therapy served as the control group. All the patients received routine therapy. The therapeutic effects were assessed using Western Aphasia Battery (WAB) before and after the therapy. The WAB item and AQ scores, curative effect, and recovery time of aphasia were compared between the 3 groups. Results The total response rate was significantly lower in the control group as compared with those in treatment groups 1 and 2 (58.06% vs 83.87% and 87.1%). WAB item scores and AQ scores, curative effect, and recovery time of aphasia all showed significant differences between the control group and the two treatment groups (P〈0.05), but not between the latter 2 groups (P〉0.05). Compared with 0.20 MPa HBO therapy, 0.175 MPa HBO therapy showed a better patient adherence with a significantly lowered non-adherence rate (by 31.37% ) an increased partial and total adherence rates (by 13.86% and 17.51%, respectively). Conclusion HBO therapy at the pressure level of 0.175 MPa is more appropriate for treatment of aphasia after craniocerebral injury to ensure the safety, efficacy and patient compliance.
作者 李琴
出处 《南方医科大学学报》 CAS CSCD 北大核心 2015年第8期1206-1210,共5页 Journal of Southern Medical University
关键词 高压氧治疗 颅脑损伤后 失语症 疗效观察 hyperbaric oxygen therapy craniocerebral injury aphasia clinical efficacy
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