南方医科大学学报

南方医科大学学报 ›› 2015, Vol. 35 ›› Issue (08): 1206-.

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颅脑损伤后失语症不同高压氧治疗压力疗效及治疗依从性观察

李琴   

  • 出版日期:2015-08-20 发布日期:2015-08-20

Hyperbaric oxygen therapy at different pressure levels for aphasia following
craniocerebral injury: efficacy, safety and patient adherence to therapy

  • Online:2015-08-20 Published:2015-08-20

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摘要： 目的探讨颅脑损伤后失语症患者给予不同压力高压氧治疗（HBO）的临床疗效及治疗依从性。方法将接受30次HBO
治疗的31例颅脑损伤后失语症患者纳入治疗1组；将2009年1月~2011年6月间接受30次HBO治疗的31例颅脑损伤后失语症
患者纳入治疗2组；将2009年1月~2013年12月间拒绝HBO治疗的31例颅脑损伤后失语症患者纳入对照组。对照组给予常规
的脑外科综合治疗，治疗组在采用综合治疗基础上，治疗1组实施0.175 MPa压力HBO治疗，治疗2组实施0.20 MPa压力HBO
治疗。观察3组治疗前后，采用西方失语症成套测验（western aphasia battery, WAB），并对组间WAB各亚项及AQ评分、疗效、
失语平均恢复时间、医嘱依从性进行比较。结果对照组有效率（58.06%）显著低于治疗1组（83.87%）和治疗2组（87.1%）。对
照组与治疗组WAB各亚项及AQ评分、疗效、失语平均恢复时间比较：差异有统计学意义（P<0.05）；治疗组间比较：差异无统计
学意义（P>0.05）。实施0.175 MPa压力与实施0.20 MPa压力HBO治疗患者医嘱依从性比较：医嘱不依从前者比后者例数减少
31.37%，医嘱部分依从增加13.86%，医嘱完全依从增加17.51%，两者差异有统计学意义（P<0.05）。结论HBO治疗颅脑损伤后
失语症患者建议采用0.175 MPa的治疗压力，可以确保安全、有效，并能增强患者医嘱依从性。

Abstract: Objective To observe the clinical effect of hyperbaric oxygen (HBO) therapy at different pressure levels on aphasia
after craniocerebral injury and assess the patient adherence to the therapies. Methods Thirty-one patients with aphasia after
craniocerebral injury receiving 30 sessions of HBO therapy at the pressure level of 0.175 MPa and another 31 patients receiving
0.2 MPa therapy were recruited as the treatment groups 1 and 2, respectively; 31 patients who refused to have HBO therapy
served as the control group. All the patients received routine therapy. The therapeutic effects were assessed using Western
Aphasia Battery (WAB) before and after the therapy. The WAB item and AQ scores, curative effect, and recovery time of
aphasia were compared between the 3 groups. Results The total response rate was significantly lower in the control group as
compared with those in treatment groups 1 and 2 (58.06% vs 83.87% and 87.1%). WAB item scores and AQ scores, curative
effect, and recovery time of aphasia all showed significant differences between the control group and the two treatment groups
(P<0.05), but not between the latter 2 groups (P>0.05). Compared with 0.20 MPa HBO therapy, 0.175 MPa HBO therapy showed
a better patient adherence with a significantly lowered non-adherence rate (by 31.37% ) an increased partial and total
adherence rates (by 13.86% and 17.51%, respectively). Conclusion HBO therapy at the pressure level of 0.175 MPa is more
appropriate for treatment of aphasia after craniocerebral injury to ensure the safety, efficacy and patient compliance.