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目的探讨高压氧治疗高血压基底核区脑出血术后患者应激性溃疡出血的发生率及治疗时机对预后的影响。方法将586例患者随机分为3组,A组:对照组;B组:术后7～14 d开始高压氧治疗;C组:术后15～30 d开始高压氧治疗。随访6个月,比较3组患者应激性溃疡出血的发生率及日常生活活动能力量表(ADL)评分。结果术后7～14 d,B组与A组、C组比较,应激性溃疡出血的发生率间差异均有统计学意义(P<0.01)。术后15～30d,C组与A组应激性溃疡出血的发生率间差异有统计学意义(P<0.01)。A、B、C 3组存活患者随访6个月时ADL评分分别为(45.7±28.8)分、(78.7±22.8)分和(62.8±28.9)分,差异有统计学意义(F=52.885,P<0.05),A组与B组、B组与C组、C组与A组比较,差异均有统计学意义(q=-33.008,P<0.01;q=15.893,P<0.01;q=17.115,P<0.01)。3组患者随访6个月时ADL评分等级间差异有统计学意义(H=69.064,P<0.05)。结论高血压基底核区脑出血术后患者的高压氧治疗应尽早进行,以术后7～14 d开始治疗疗效最好,虽增加应激性溃疡出血的发生率,但并不影响高压氧治疗的疗效,可明显降低致残率。
Objective To investigate the incidence of stress ulcer bleeding in patients with hypertensive basal ganglia after intracerebral hemorrhage and the effect of treatment timing on prognosis. Methods 586 patients were randomly divided into 3 groups: group A: control group; group B: hyperbaric oxygen therapy started 7-14 days after operation; group C: hyperbaric oxygen therapy started 15-30 days after operation. The patients were followed up for 6 months. The incidence of stress ulcer bleeding and ADL score were compared between the three groups. Results The incidence of stress ulcer bleeding in group B was significantly higher than that in group A and group C at 7 to 14 days postoperatively (P <0.01). Between the 15th and 30th postoperative days, there was a significant difference in the incidence of stress ulcer among group C and group A (P <0.01). ADL scores of (45.7 ± 28.8), (78.7 ± 22.8) and (62.8 ± 28.9) points in group A, B and C at 6 months of follow-up were statistically significant (F = 52.885, P (P <0.01); q = 15.893, P <0.01; q = 17.115 (P <0.01). There was a significant difference between group A and group B, group B and group C, group C and group A. , P <0.01). There was a significant difference in ADL grade between the three groups at 6 months follow-up (H = 69.064, P <0.05). Conclusion Hyperbaric oxygen therapy should be done as soon as possible in patients with hypertensive nucleus of cerebral hemorrhage, and the best effect is to be started from 7 to 14 days after operation. Although it increases the incidence of stress ulcer bleeding, it does not affect hyperbaric oxygen therapy The curative effect can obviously reduce the disability rate.