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背景:既往认为高压氧可以防治脑卒中,但有学者认为高压氧治疗中反而可诱发脑卒中,其发生因素以及以何种药物防治尚不甚清楚。目的:探讨高压氧诱发脑血栓形成的原因及药物的预防作用。设计:以患者为研究对象的回顾性研究。单位:一所军区总医院的高压氧科。对象:1996-12/1998-08广州军区广州总医院行高压氧治疗的的192例住院患者,其中男127例,女65例,年龄9～78岁。治疗中发生脑血栓形成的患者共6例,男女各3例,年龄51～76岁。方法:对192例行高压氧治疗患者及其中发生的6例脑血栓形成患者的背景因素进行分析,将192例患者分为3组:①硝酸酯类组。②钙拮抗组。③未特殊用药组,在不同危险因子簇集水平上分析药物的预防作用。对192例行高压氧治疗的3组患者在常规使用活血化瘀、神经营养、血管扩张剂等药物的前提下,硝酸酯类组口服消心痛或硝酸甘油,钙拮抗剂组口服西比灵或络活喜等,未特殊用药组则没有预防性使用药物。主要观察指标:患者的症状、体征以及头颅CT或MRI。结果:高压氧诱发脑血栓形成以高脂血症、高血压病等基础疾病为危险因子,危险因子簇集4个以下者共115例,无一例发病,4个或4个以上者共31例,有6例发病,发病率大为增加;在4个危险因子的水平上,硝酸酯类药物有有效的预防作用(0/13),而钙拮抗剂组中有33.
Background: Previously considered that hyperbaric oxygen can prevent stroke, but some scholars believe that hyperbaric oxygen therapy can actually induce stroke, its causes and what kind of drug control is not yet clear. Objective: To investigate the causes of hyperbaric oxygen-induced cerebral thrombosis and the preventive effect of drugs. Design: A retrospective study of patients. Unit: a Military Region General Hospital of hyperbaric oxygen. PARTICIPANTS: A total of 192 hospitalized patients undergoing hyperbaric oxygen therapy from Guangzhou General Hospital of Guangzhou Military Command from December 1996 to August 1998, including 127 males and 65 females, aged 9 to 78 years. A total of 6 patients with cerebral thrombosis occurred during treatment, 3 males and 3 females, aged 51-76 years. Methods: 192 patients with hyperbaric oxygen treatment and 6 cases of cerebral thrombosis in patients with background factors were analyzed, 192 patients were divided into 3 groups: ① nitrate group. ② calcium antagonist group. ③ no special drug group, in different levels of risk factors clustering analysis of drug preventive effect. 192 patients undergoing hyperbaric oxygen therapy in the three groups of patients in the conventional use of blood circulation, neurotrophic, vasodilators and other drugs under the premise of nitric acid ester group of oral anti-heart pain or nitroglycerin, calcium antagonist group oral Sibelium or Lo dex, etc., no special medication group did not prevent the use of drugs. MAIN OUTCOME MEASURES: Patient’s symptoms and signs as well as cranial CT or MRI. Results: Hyperbaric oxygen-induced cerebral thrombosis with hyperlipidemia, hypertension and other underlying diseases as risk factors, risk factors cluster of four were 115 cases, no case of onset, 4 or more than 4 cases were 31 cases , With a 6-case incidence and a significantly increased incidence; nitrates were effective prophylactic (0/13) at 4 risk factors compared with 33 in the calcium antagonist group.