目的:探讨高压氧(hyperbaric oxygen,HBO)对颅内血肿清除术后阵发性交感神经过度兴奋综合征(paroxysmal sympathetic hyperactivity,PSH)的疗效。方法:对药物治疗难以控制症状发作的3例颅内血肿清除术后并发PSH的患者分别于术后第16、21、52天行HBO治疗,评价HBO对PSH的疗效以及患者的预后。结果:3例患者经3次HBO治疗,PSH症状明显缓解,临床症状量表(clinical feature scale,CFS)评分明显下降;经5~7次HBO治疗后,PSH症状完全消失。结论:HBO治疗对于药物难治的PSH患者具有良好的疗效,同时也可改善患者预后。
Objective:To evaluate the effect of early hyperbaric oxygen therapy (HBOT) on neurological function recovery of basal ganglia hemorrhage patients who didn’t receive hematoma evacuation.Methods:A total of 41 basal ganglia hemorrhage patients treated in Nanjing Zijin Hospital and PLA Air Force Hospital of The Eastern Theater Command from January 2015 to January 2020 were included in this study. They did not undergo hematoma evacuation surgery due to small hematoma volume, 18 of whom received early HBOT (treatment group), and the remaining 23 patients received the same HBOT two weeks after hemorrhage (control group). The hematoma volume and the changes of perihematomal edema (PHE) were observed using regular head CT scan, and the incidences of PHE expansion in the two groups were compared on the 10th day after the hemorrhage. All the 41 patients’ neurological functions were assessed by the National Institutes of Health stroke scale (NIHSS) and Glasgow outcome scale (GOS) upon their admission and three months after admission.Results:No re-hemorrhage was found in any patient on the head CT scan. On the 10th day after admission, the incidence of PHE expansion was 16.7% in the treatment group and 91.3% in the control group, respectively, the difference was statistically significant ( P<0.01). After three months of treatment, the NIHSS scores of both groups were decreased, and the GOS scores of both groups were increased. The NIHSS score of the treatment group was lower than that of the control group, while the GOS score in the treatment group was higher than that of the control group, both with statistically significant differences ( P<0.05). Conclusion:Early HBOT is a safe treatment for basal ganglia hemorrhage patients without hematoma evacuation, and it can reduce the occurrence of PHE and improve the prognosis of patients.