Duan Yaqin,Zhang Jinwei,Hu Jihong,et al.Effect of hyperbaric oxygen therapy plus goal-directed training on MRI-SWI,GMFM,balance and ADL in cerebral hemorrhage children[J].Journal of Clinical Pediatric Surgery,,():752-757.[doi:10.3760/cma.j.cn101785-202409045-009]
Effect of hyperbaric oxygen therapy plus goal-directed training on MRI-SWI,GMFM,balance and ADL in cerebral hemorrhage children
- Keywords:
- Cerebral Hemorrhage; Spontaneous; Hyperbaric Oxygenation; Target-oriented Planning; Treatment Outcome; Child
- Abstract:
- Objective To explore the effect of hyperbaric oxygen therapy (HBOT) plus target-oriented planning (GDT) on children during the recovery phase of intracerebral hemorrhage (ICH). Methods For this prospective study,30 children with spontaneous ICH were treated at Hunan Children‘s Hospital between January 2020 and December 2023.Based upon the specific inclusion and exclusion criteria,they were randomized into either HBOT+GDT group (n=15) or conventional physical rehabilitation therapy group (n=15).The relevant outcome measures included maximum cross-sectional area of brain injury assessed by magnetic resonance imaging plus susceptibility weighted imaging (MRI-SWI),Gross Motor Function Measure-88 (GMFM-88) score,Berg Balance Scale (BBS) score and Activity of Daily Living (ADL) score.And 12-week follow-ups were conducted for evaluating the intervention effects in both groups. Results After adjusting for baseline values,analysis of covariance (ANCOVA) revealed significant differences between HBOT+GDT and conventional therapy groups post-intervention.HBOT+GDT group demonstrated a significantly lowered MRI-SWI maximum cross-sectional area (2.302±0.12 vs.4.77±0.12 cm2),higher BBS score (34.294±0.99 vs.27.570±0.99),greater GMFM-88 total percentage (65.90%±1.19% vs.55.87%±1.19%) and higher ADL score (58.04±1.14 vs.48.98±1.14).All differences were statistically significant (P<0.05). Conclusions HBOT+GDT may improve brain injury and promote the recovery of motor function and ADL capabilities in children with spontaneous ICH.
References:
[1] Broderick J,Talbot GT,Prenger E,et al.Stroke in children within a major metropolitan area: the surprising importance of intracerebral hemorrhage[J].J Child Neurol,1993,8(3):250-255.DOI:10.1177/088307389300800308.
[2] 孟艳举,宋来君,郭付有,等.儿童自发性脑出血病因及临床特点分析[J].中国现代神经疾病杂志,2014,14(1):47-50.DOI:10.3969/j.issn.1672-6731.2014.01.011. Meng YJ,Song LJ,Guo FY,et al.Causes and clinical characteristics of spontaneous intracerebral hemorrhage in children[J].Chin J Contemp Neurol Neurosurg,2014,14(1):47-50.DOI:10.3969/j.issn.1672-6731.2014.01.011.
[3] 王海涛,陈鑫,孟淼,等.高压氧治疗脑出血的研究进展[J].中华航海医学与高气压医学杂志,2024,31(4):567-570.DOI:10.3760/cma.j.cn311847-20230302-00045. Wang HT,Chen X,Meng M,et al.Research advances of hyperbaric oxygen therapy for cerebral hemorrhage[J].Chin J Naut Med Hyperbar Med,2024,31(4): 567-570.DOI:10.3760/cma.j.cn311847-20230302-00045.
[4] Elliott CM,Reid SL,Alderson JA,et al.Lycra arm splints in conjunction with goal-directed training can improve movement in children with cerebral palsy[J].NeuroRehabilitation,2011,28(1):47-54.
[5] 张立新.目标导向式重复性功能训练联合高压氧治疗对高血压脑出血患者的效果观察[J].大医生,2024,9(2):127-130.DOI:10.3969/j.issn.2096-2665.2024.02.042. Zhang LX.Observation of the effect of target-oriented repetitive functional training plus hyperbaric oxygen therapy on patients with hypertensive intracerebral hemorrhage[J].Doctor,2024,9(2):127-130.DOI:10.3969/j.issn.2096-2665.2024.02.042.
[6] 周新管,王磊,任登鹏,等.血肿抽吸术联合高压氧治疗对脑出血大鼠脑组织的保护作用[J].中华航海医学与高气压医学杂志,2022,29(1):93-98.DOI:10.3760/cma.j.cn311847-20210112-00015. Zhou XG,Wang L,Ren DP,et al.Protective effects of hematoma aspiration plus hyperbaric oxygen therapy on rat brain tissue with cerebral hemorrhage[J].Chin J Naut Med Hyperbar Med,2022,29(1):93-98.DOI:10.3760/cma.j.cn311847-20210112-00015.
[7] 潘强,朱琳,高勇,等.基因沉默诱导型环氧化酶协同高压氧对脑出血大鼠神经功能修复及细胞凋亡、自噬的影响[J].中华急诊医学杂志,2024,33(1):39-46.DOI:10.3760/cma.j.issn.1671-0282.2024.01.007. Pan Q,Zhu L,Gao Y,et al.Effects of gene silencing cyclooxygenase-2 cooperating with hyperbaric oxygen on neurological repair and apoptosis,autophagy in cerebral hemorrhage rats[J].Chin J Emerg Med,2024,33(1):39-46.DOI:10.3760/cma.j.issn.1671-0282.2024.01.007.
[8] 王晶,李红玲,谢冬玲,等.不同疗程高压氧治疗对脑出血大鼠血肿周围Bax和Bcl-2表达的影响[J].中华物理医学与康复杂志,2020,42(1):72-74.DOI:10.3760/cma.j.issn.0254-1424.2020.01.018. Wang J,Li HL,Xie DL,et al.Effects of different courses of hyperbaric oxygen therapy on the expression of Bax and Bcl-2 around hematoma in rats with cerebral hemorrhage[J].Chin J Phys Med Rehabil,2020,42(1):72-74.DOI:10.3760/cma.j.issn.0254-1424.2020.01.018.
[9] 潘强,朱琳,张帅,等.siRNA干扰技术联合高压氧对大鼠脑出血后脑水肿及凋亡的影响[J].中华老年医学杂志,2017,36(9):1010-1014.DOI:10.3760/cma.j.issn.0254-9026.2017.09.018. Pan Q,Zhu L,Zhang S,et al.Effects of siRNA interference plus hyperbaric oxygen treatment on cerebral edema and apoptosis in brain tissue of rats after hemorrhage[J].Chin J Geriatr,2017,36(9):1010-1014.DOI:10.3760/cma.j.issn.0254-9026.2017.09.018.
[10] 包金风,黄博雅,宁荣霞,等.高压氧通过线粒体途径对一氧化碳中毒迟发性脑病小鼠的保护作用及机制[J].中华急诊医学杂志,2023,32(3):319-326.DOI: 10.3760/cma.j.issn.1671-0282.2023.03.008. Bao JF,Huang BY,Ning RX,et al.Protective effect and mechanism of hyperbaric oxygen on delayed encephalopathy after carbon monoxide poisoning via mitochondrial pathway in mice[J].Chin J Emerg Med,2023,32(3):319-326.DOI: 10.3760/cma.j.issn.1671-0282.2023.03.008.
[11] Ren BY,Ye HB,Shan WY,et al.Effect of hyperbaric oxygen intervention on oxidative stress and expression of nerve growth factor in patients with craniocerebral injury[J].J Inflamm Res,2023,16:4925-4932.DOI:10.2147/JIR.S422790.
[12] Boussi-Gross R,Golan H,Fishlev G,et al.Hyperbaric oxygen therapy can improve post concussion syndrome years after mild traumatic brain injury-randomized prospective trial[J].PLoS One,2013,8(11):e79995.DOI:10.1371/journal.pone.0079995.
[13] Nathan DE,Prost RW,Guastello SJ,et al.Investigating the neural correlates of goal-oriented upper extremity movements[J].Neuro Rehabilitation,2012,31(4): 421-428.DOI:10.3233/NRE-2012-00812.
[14] Lacerenza M,Frabasile L,Buttafava M,et al.Motor cortex hemodynamic response to goal-oriented and non-goal-oriented tasks in healthy subjects[J].Front Neurosci,2023,17:1202705.DOI:10.3389/fnins.2023.1202705.
[15] 戚聪聪,王成,郭宇闻.MRI常规序列和磁敏感成像序列诊断脑出血面积及血量的价值对比[J].浙江创伤外科,2023,28(9):1759-1762.DOI:10.3969/j.issn.1009-7147.2023.09.049. Qi CC,Wang C,Guo YW.Comparison of diagnostic value of MRI routine sequence and magnetic sensitivity imaging sequence for cerebral hemorrhage area and blood volume[J].Zhejiang J Traumat Surg,2023,28(9):1759-1762.DOI: 10.3969/j.issn.1009-7147.2023.09.049.
[16] 谢芹,尤春景.高压氧对实验性脑出血大鼠的治疗作用[J].中国康复,2004,19(2):75-77.DOI:10.3870/j.issn.1001-2001.2004.02.004 Xie Q,You CJ.Effect of hyperbaric oxygen on cerebral hemorrhage in rats[J].Chin J Rehabil,2004,19(2):75-77.DOI:10.3870/j.issn.1001-2001.2004.02.004.
[17] 林少娟,黄梅秀,梁云云,等.高压氧治疗高血压脑出血患者的疗效观察[J].国际医药卫生导报,2014,20(5):643-645.DOI:10.3760/cma.j.issn.1007-1245.2014.05.019. Lin SJ,Huang MX,Liang YY,et al.Clinical effect of hyperbaric oxygen for patients with hypertension hemorrhage[J].Int Med Health Guid News,2014,20(5): 643-645.DOI:10.3760/cma.j.issn.1007-1245.2014.05.019.
[18] 吴德萍,刘智程,高劼,等.基于目标导向性训练对重度脑性瘫痪儿童运动功能的影响[J].中国康复医学杂志,2024,39(3): 334-339,346.DOI:10.3969/j.issn.1001-1242.2024.03.005. Wu DP,Liu ZC,Gao J,et al.Effects of goal-directed training on motor function in children with severe cerebral palsy[J].Chin J Rehabil Med,2024,39(3): 334-339,346.DOI:10.3969/j.issn.1001-1242.2024.03.005.
[19] Rozevink SG,Beerepoot CM,van der Sluis CK,et al.Standardized circuit class group training versus individualized goal-directed group training to improve upper limb function in stroke survivors during in-patient rehabilitation: a pragmatic trial[J].Disabil Rehabil,2024,46(16):3660-3672.DOI:10.1080/09638288.2023.2255135.
Memo
收稿日期:2024-9-15。
基金项目:湖南省中医药科研课题(C2024022);湖南省自然科学基金面上项目(2025JJ50682);长沙市科技厅软科学项目(kh2502016)
通讯作者:吴水华,Email:292454021@qq.com;梁大中(Dae-jung Yang),Email:pt6226@sehan.ac.kr