Objective To investigate the influence of hyperbaric oxygen (HBO) on blood pressure and heart rate in adult patients with cervical spinal cord injury (SCI) and its related factors.Methods From May 2015 to October 2017, 101 cases of adult cervical spinal cord injury in our department were selected as observation group, who were divided into four subgroups (AIS A~D) respectively, according to the ASIA score. Other 101 cases of sudden hearing loss without spinal cord injury were selected as control group, who were divided into four subgroups with gender and age matched with four subgroups of the observation group, respectively. Blood pressure and heart rate were measured before the compression, at the end of the compression, 30 minutes after oxygen taken in, before the decompression and at the end of the decompression; and were compared between groups. The fluctuations of blood pressure and heart rate were correlated and regression analyzed with age, course and AISA score respectively.Results In ASI A~C, the blood pressure fluctuated obviously during the course of hyperbaric oxygen therapy in the observation group (P<0.05). There was no significant difference in blood pressure between ASI D of the observation group and their controls (P>0.05). Lower extremity motor score of ASIA was correlated with the fluctuation of blood pressure (P<0.05).Conclusion The blood pressure fluctuates in patients with cervical spinal cord injury (AIS A~C) during hyperbaric oxygen, which should be paid attention to. Lower extremity motor score of ASIA is an independent factor affecting blood pressure. The higher the lower extremity motor score, the smaller the blood pressure fluctuation.
DU Juan
,
ZHAO Hai-ping
,
ZHANG Cai
,
TIAN Xue-mei
. Influence of Hyperbaric Oxygen on Blood Pressure and Heart Rate in Adult Patients with Cervical Spinal Cord Injury and Its Related Factors[J]. Chinese Journal of Rehabilitation Theory and Practice, 2018
, 24(6)
: 702
-708
.
DOI: 10.3969/j.issn.1006-9771.2018.06.015
[1] 胡家美,乐敏莉,段宜强. 高位脊髓损伤血压、心率变化的临床观察[J]. 实用医学杂志, 2008, 24(20): 3519-3521.
[2] 朱颖,刘立君. 颈段脊髓损伤24 h动态血压临床观察[J]. 中国康复理论与实践, 2012, 18(8): 773-775.
[3] 逯晓蕾,周红俊,刘根林,等. 颈髓损伤后血压和心率变化的有关研究[J]. 中国康复理论与实践, 2014, 20(2): 153-155.
[4] Teasell RW, Arnold JM, Krassioukov A, et al.Cardiovascular consequences of loss of supraspinal control of the sympa-thetic nervous system after spinal cord injury[J]. Arch Phys Med Rehabil, 2000, 81(4): 506-516.
[5] Wang Y, Zhang S, Luo M, et al.Hyperbaric oxygen therapy improves local microenvironment after spinal cord injury[J]. Neural Regen Res, 2014, 9(24): 2182-2188.
[6] 李庆伟,章旭,孔祥清,等. 创伤性颈髓损伤后急性期患者血钙、心率、血压与其Frankel分级的相关性[J]. 中华临床医师杂志(电子版), 2016, 10(20): 3025-3028.
[7] 姚爱明,关骅,张贵平,等. 脊髓损伤后体位性低血压的临床研究[J]. 中国康复医学杂志, 2005, 20(1): 50-53.
[8] 蒋显锋,汤锋武,陈旭义,等. 高压氧治疗对外伤性颈段脊柱、脊髓损伤外科手术治疗效果的影响[J]. 中国实用神经疾病杂志, 2016, 19(8): 87-88.
[9] Yang J, Wang G, Gao C, et al.Effects of hyperbaric oxygen on MMP-2 and MMP-9 expressions and spinal cord edema after spinal cord injury[J]. Life Sci, 2013, 93(25-26): 1033-1038.
[10] 孙文志,鲁世保. 高压氧治疗脊髓损伤机制的研究进展[J]. 中国脊柱脊髓杂志, 2014, 24(12): 1116-1119.
[11] 郑云锋,张春满. 高压氧联合甲泼尼龙及神经节苷脂治疗急性脊髓损伤的疗效[J]. 神经损伤与功能重建, 2016, 11(3): 258-259.
[12] Liu X, Zhou Y, Wang Z, et al.Effect of VEGF and CX43 on the promotion of neurological recovery by hyperbaric oxygen treatment in spinal cord -injured rats[J]. Spine J, 2014, 14(1): 119-127.
[13] 乔苏迟,陈晓,李诚,等. 甲泼尼龙联合高压氧治疗对大鼠脊髓损伤的保护作用[J]. 上海医学, 2015, 38(2): 147-150.
[14] 俞友皆,黄莘莘. 早期高压氧治疗对不完全性颈髓损伤患者神经功能恢复的影响[J]. 实用医学杂志, 2008, 24(9): 1559-1561.
[15] 李建军,王方永. 脊髓损伤神经学分类国际标准(2011年修订)[J]. 中国康复理论与实践, 2011, 17(10): 963-972.
[16] 王文,张维忠,孙宁玲,等. 中国血压测量指南[J]. 中华高血压杂志, 2011, 19(12): 1101-1115, 1100.
[17] 张良,胡慧军,杨晨,等. 高压氧治疗对患者血压及心率变化的影响[J]. 中华航海医学与高气压医学杂志, 2010, 17(1): 29-32.
[18] Heyboer Rd M, Wojcik SM, Smith G, et al.Effect of hyperbaric oxygen therapy on blood pressure in patients undergoing treatment[J]. Undersea Hyperb Med, 2017, 44(2): 93-99.
[19] Al-Waili NS, Butler GJ, Beale J, et al.Influences of hyperbaric oxygen on blood pressure, heart rate and blood glucose levels in patients with diabetes mellitus and hypertension[J]. Arch Med Res, 2006, 37(8): 991-997.
[20] 刘燕,胡友军,石尚金,等. 高压氧治疗对中老年患者血压的影响[J]. 中国临床康复, 2002, 6(15): 2284.
[21] Van der Bel R, Çalişkan M, van Hulst RA, et al. Blood pressure increase during oxygen supplementation in chronic kidney disease patients is mediated by vasoconstriction independent of baroreflex function[J]. Front Physiol, 2017, 30(8): 186.
[22] Chateau-Degat ML, Poitras J, Abraini JH.Hemodynamic profiles of intubated and mechanically ventilated carbon monoxide-poisoned patients during systemic hyperbaric oxygen therapy[J]. BMC Anesthesiol, 2013, 13(1): 26.
[23] Chateau-Degat ML, Belley R.Hyperbaric oxygen therapy decreases blood pressure in patients with chronic wounds[J]. Undersea Hyperb Med, 2012, 39(5): 881-889.
[24] 杜娟,张才,田雪梅. 高压氧治疗对成年脊髓损伤患者血压和心率的影响[J]. 中国康复理论与实践, 2016, 22(3): 314-319.
