在复杂的大动脉修复后脊髓缺血的辅助高压氧气疗法
Angela Lee1, Rita Katznelson2, Maral Ouzounian3
1Division of Vascular Surgery, Toronto General Hospital, Toronto, Ontario, Canada.
Journal of vascular surgery
|November 4, 2023
概括
高压氧气疗法 (HBOT) 可能在复杂的大动脉修复 (CAR) 并发症后改善脊髓功能恢复. 然而,好处各不相同,有些患者完全康复,而有些人则仅略有改善.
科学领域:
- 神经外科 神经外科
- 心血管外科心血管外科
- 高压医学的高压医学.
背景情况:
- 脊髓缺血 (SCI) 是复杂的大动脉修复 (CAR) 后的一种严重并发症.
- 标准的SCI治疗包括脑脊液排水,血红蛋白维持和血压管理.
- 在之前的研究中,高压氧气疗法 (HBOT) 在改善SCI结局方面表现有前途.
研究的目的:
- 为了评估HBOT作为SCI后CAR的救援治疗的有效性.
- 评估在接受HBOT的患者中除了标准护理之外的运动功能的恢复.
主要方法:
- 从2013年1月到2021年6月,对SCI后CAR的HBOT治疗进行了回顾性审查.
- 在不同时间点 (HBOT前,HBOT后,最终评估) 使用线性混合模型分析运动功能的得分.
- 亚组分析比较了改善和不改善的患者之间的运动功能的改善.
主要成果:
- 30名患有SCI后CAR的患者接受了HBOT.
- 14名患者的运动功能有所改善,其中8人完全康复.
- 十名四肢患者中有七名在接受HBOT时没有显著改善.
- 总体肌肉功能得分显示,从HBOT前到最终评估 (6.7分) 的平均增加.
结论:
- 作为标准治疗的辅助,HBOT可能为CAR后的脊髓功能恢复提供潜在的好处.
- 在SCI之后,HBOT在改善运动功能的有效性在所有患者亚组中并不均.
- 需要进一步的研究来确定预测对HBOT反应的患者特征.
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