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背景:既往认为高压氧可以防治脑梗死,但有报道高压氧也可诱发其发生,其发生原因尚不甚清楚。目的:探讨高压氧诱发脑梗死的原因。设计:病例分析。单位:解放军广州军区广州总医院高压氧科。对象:选择1996-12/1998-03在广州军区广州总医院高压氧科行高压氧治疗的192例住院患者。男127例,女65例,年龄9～78岁。纳入标准:①因缺氧、缺血性疾病,或由于缺氧、缺血引起的一系列疾病且无高压氧治疗的禁忌证在高压氧科住院治疗的患者。②年龄、性别不限。③患者及家属知情同意。不符合上述标准或虽符合上述标准但未做高压氧治疗的住院患者为排除标准。脑梗死诊断及治愈标准:按照《临床疾病诊断依据治愈好转标准》,治疗中发生脑梗死的患者共6例,男女各3例,年龄51～76岁。方法:高压氧治疗:采用多人空气加压舱,治疗压力为0.2MPa(2.0ATA),面罩吸纯氧40min2次,中间间歇吸空气10min,1次/d,每10次为1个疗程。对6例发生脑梗死患者、186例未发生脑梗死患者的背景因素及其危险因子水平进行分析。主要观察指标:高压氧治疗诱发脑梗死患者危险因子分布及未发生脑梗死患者危险因子水平分析。结果:①6例患者均有高脂血症,5例有高血压,5例原有脑梗死或脑出血,4例年龄≥60岁或有高黏血症,有糖尿病者1例。6例患者的危险因子数在4个以上,存在危险因子簇集性。②6例发生脑梗死患者中含4个危险因子的有5例,含5个危险因子的1例。186例未发生脑梗死患者中含4个危险因子的有25例,含5个危险因子的0例,其危险因子蔟集性相对较小(χ2=54.37,P<0.005)。结论:发生脑梗死患者均存在危险因子簇集性,危险因子的簇集性水平与高压氧诱发脑梗死概率有密切关系。
Background: In the past, hyperbaric oxygen could prevent cerebral infarction, but hyperbaric oxygen was also reported to induce its occurrence, the reason for which is not clear yet. Objective: To investigate the causes of hyperbaric oxygen-induced cerebral infarction. Design: Case Analysis. Unit: People’s Liberation Army Guangzhou Military Region Guangzhou General Hospital hyperbaric oxygen. PARTICIPANTS: A total of 192 hospitalized patients undergoing hyperbaric oxygen therapy at the Guangzhou General Hospital of Guangzhou Military Command from January 1996 to March 1998 were selected. 127 males and 65 females, aged 9 to 78 years. Inclusion criteria: ① Patients hospitalized in hyperbaric oxygenation due to hypoxia, ischemic disease, or a series of illnesses caused by hypoxia and ischemia without hyperbaric oxygen therapy. ② age, gender is not limited. ③ patients and their families informed consent. Inconsistent with the above criteria or although meet the above criteria but not hyperbaric oxygen therapy hospital patients excluded criteria. Diagnosis and cure criteria for cerebral infarction: According to “clinical disease diagnosis based on improvement criteria for treatment,” the treatment of cerebral infarction in patients with a total of 6 patients, 3 males and 3 females, aged 51 to 76 years. Methods: hyperbaric oxygen therapy: multi-person air pressurization tank, the treatment pressure of 0.2MPa (2.0ATA), mask suction pure oxygen 40min2 times, the middle intermittent air suction 10min, 1 times / d, every 10 times for a course of treatment. Six patients with cerebral infarction, 186 patients without cerebral infarction background factors and risk factors were analyzed. MAIN OUTCOME MEASURES: Distribution of risk factors in patients with cerebral infarction induced by hyperbaric oxygen therapy and analysis of risk factors in patients without cerebral infarction. Results: ① All 6 patients had hyperlipidemia, 5 had hypertension, 5 had original cerebral infarction or cerebral hemorrhage, 4 had hyperviscosity ≥ 60 or had hyperviscosity, and 1 had diabetes. Six patients had more than four risk factors, with clustering of risk factors. There were 5 cases with 4 risk factors in 6 patients with cerebral infarction and 1 patient with 5 risk factors. Of the 186 patients without cerebral infarction, 25 contained 4 risk factors and 0 contained 5 risk factors, and their risk factors were relatively low (χ2 = 54.37, P <0.005). Conclusion: There is clustering of risk factors in patients with cerebral infarction. The clustering level of risk factors is closely related to the probability of cerebral infarction induced by hyperbaric oxygen.