探讨高压氧治疗脑出血微创血肿清除术后患者的疗效。

选取2022年8月至2024年8月淳安县第一人民医院神经外科收治的126例脑出血患者作为研究对象，其中男性82例，女性44例；年龄40 ~ 70岁[（58.17±10.69）岁]。将研究对象按照是否应用高压氧治疗分为观察组和对照组，每组各63例。对照组予以脑出血微创血肿清除术，观察组在术后24 h内予以高压氧治疗，以术后14 d美国国立卫生研究院卒中量表（NIHSS）评分为主要终点，术后NIHSS评分随时间的变化情况、脑水肿体积、氧化应激水平[丙二醛（MDA）、谷胱甘肽过氧化物酶（GSH-Px）及超氧化物歧化酶（SOD）]、不良事件为次要终点。采用Pearson相关系数法分析同一时间点氧化应激指标与NIHSS评分间的关系。

采用两因素重复测量方差分析显示，NIHSS评分、脑水肿体积及氧化应激指标MDA、GSH-Px、SOD的组别主效应、时间主效应、组别与时间交互效应差异均有统计学意义（P<0.05）。简单效应分析提示：两组患者NIHSS评分、脑水肿体积、MDA水平随时间延长逐步降低，GSH-Px、SOD水平随时间延长逐步升高；术前两组上述指标差异均无统计学意义（P>0.0125），术后3、7及14 d观察组NIHSS评分、脑水肿体积、MDA水平低于对照组，GSH-Px、SOD水平高于对照组（P<0.0125）。相关性分析显示，各时间点NIHSS评分与同期MDA水平呈正相关，与同期GSH-Px、SOD水平呈负相关（P<0.05）。两组不良事件发生率差异无统计学意义（P>0.05）。

采用高压氧治疗脑出血微创血肿清除术后患者，能够减轻脑水肿、降低氧化应激水平，改善患者神经功能。

To investigate the efficacy of hyperbaric oxygen therapy in patients following minimally invasive evacuation of intracranial hematoma.

A retrospective study was performed on 126 patients with intracerebral hemorrhage admitted to the Department of Neurosurgery, The First People's Hospital of Chun'an County between August 2022 and August 2024, including 82 males and 44 females, aged 40~70 years [(58.17±10.69) years]. The participants were assigned to an observation group and a control group according to whether hyperbaric oxygen (HBO) therapy was administered, with 63 patients in each group. Patients in the control group received minimally invasive hematoma evacuation for intracerebral hemorrhage. The observation group received HBO therapy within 24 hours after surgery. The primary endpoint was the National Institutes of Health Stroke Scale (NIHSS) score at postoperative day 14. Secondary endpoints included the temporal changes in postoperative NIHSS scores, cerebral edema volume, oxidative stress levels [malondialdehyde (MDA)、glutathione peroxidase (GSH-Px), superoxide dismutase (SOD)], and adverse events. Pearson correlation analysis was adopted to explore the correlation between oxidative stress indicators and NIHSS scores at the same time point.

Two-way repeated-measures analysis of variance revealed statistically significant main effects of group, main effects of time, and group-by-time interaction effects for NIHSS score, cerebral edema volume, and oxidative stress indicators including MDA, GSH-Px and SOD (all P<0.05). Simple effect analyses indicated that the NIHSS score, cerebral edema volume and MDA level gradually decreased over time, while GSH-Px and SOD levels gradually increased in both groups. No significant intergroup differences in the above indicators were observed before operation (P>0.0125). At postoperative day 3, 7 and 14, the observation group exhibited lower NIHSS scores, smaller cerebral edema volume and lower MDA levels, as well as higher GSH-Px and SOD levels compared with the control group (all P<0.0125). Correlation analysis showed that the NIHSS score at each time point was positively correlated with the concurrent MDA level, and negatively correlated with concurrent GSH-Px and SOD levels (all P<0.05). There was no statistically significant difference in the incidence of adverse events between the two groups (P>0.05).

Hyperbaric oxygen therapy after minimally invasive hematoma evacuation for intracerebral hemorrhage reduces cerebral edema, decreases oxidative stress levels, and improves neurological function.