临床与病理杂志2025，Vol.45Issue(8)：999-1006,8.DOI:10.11817/j.issn.2095-6959.2025.250372
长疗程高压氧治疗脑出血继发性脑积水分流术后慢性意识障碍患者的疗效
Efficacy of long-term hyperbaric oxygen therapy in patients with chronic disorders of consciousness after ventriculoperitoneal shunt for secondary hydrocephalus following intracerebral hemorrhage
摘要
Abstract
Objective:The number of patients with consciousness disorders caused by intracerebral hemorrhage has increased annually,and secondary hydrocephalus is an important risk factor affecting prognosis.Timely and appropriate ventriculoperitoneal shunt can improve outcomes,but some patients remain in prolonged disorders of consciousness(pDOC)after surgery.Recent studies suggest that hyperbaric oxygen(HBO)therapy may facilitate consciousness recovery.This study aims to evaluate the efficacy of long-term HBO therapy in pDOC patients following ventriculoperitoneal shunt for secondary hydrocephalus after intracerebral hemorrhage. Methods:Clinical data of patients admitted to Nanjing Zijin Hospital between January 2020 and December 2023 with pDOC secondary to intracerebral hemorrhage who had undergone ventriculoperitoneal shunt and received≥20 sessions of HBO therapy were retrospectively analyzed.Patients were divided into an observation group(effective response)and a control group(ineffective response)according to treatment outcomes.The Chinese Nanjing Persistent Vegetative State Scale(CNPVSS)and the Glasgow Coma Scale(GCS)were used to assess consciousness levels.Changes in CNPVSS,GCS,and electroencephalogram(EEG)scores before and after treatment were compared between groups. Results:A total of 52 patients were included,with 41 in the observation group and 11 in the control group.No significant differences were found between the 2 groups in terms of gender,age,cause of hemorrhage,or baseline GCS,CNPVSS,and EEG scores(all P>0.05).The average number of HBO sessions was 104.32±47.28 in the observation group and 69.00±44.42 in the control group,with a statistically significant difference(P<0.05).Before HBO treatment,33(63.46%)patients were in a vegetative state(VS)and 19(36.54%)were in a minimally conscious state(MCS);after treatment,38(73.08%)patients achieved MCS or regained consciousness.In the observation group,GCS,CNPVSS,and EEG scores all improved significantly after treatment(all P<0.05),whereas no significant changes were observed in the control group(all P>0.05).Post-treatment GCS and CNPVSS scores were significantly higher in the observation group than in the control group(both P<0.05),but EEG scores showed no significant difference(P>0.05). Conclusion:Long-term HBO therapy can significantly promote the recovery of consciousness in patients with pDOC after ventriculoperitoneal shunt for secondary hydrocephalus following intracerebral hemorrhage.The CNPVSS and GCS are sensitive indicators for evaluating treatment efficacy and are worthy of clinical application.关键词
脑出血/脑积水/脑积水分流术后/慢性意识障碍/高压氧治疗Key words
intracerebral hemorrhage/hydrocephalus/ventriculoperitoneal shunt/chronic disorder of consciousness/hyperbaric oxygen therapy引用本文复制引用
王霞,章桂霞,孙曼曼,詹婷,崔霖霖,张治元..长疗程高压氧治疗脑出血继发性脑积水分流术后慢性意识障碍患者的疗效[J].临床与病理杂志,2025,45(8):999-1006,8.基金项目
STI数字医疗实验室开放基金(2024STI022).This work was supported by the STI Digital Healthcare Laboratory Open Fund,China(2024STI022). （2024STI022）
