The Effect Of Hyperbaric Oxygen Therapy On Long-term Prognosis In Patients With Ischemic Stroke

Objective:The aim of this study was to investigate the long-term effect and safety of hyperbaric oxygen therapy for patients with ischemic stroke.Meanwhile to discuss the starting time of hyperbaric oxygen therapy for ischemic stroke.Method:1.This trial adopted real world,prospective,cohort research method.All 127 participants suffered a ischemic stroke in 90 days and were hospitalized in the Department of Hyperbaric Oxygen of Sichuan Provincial People’s Hospital from December 2013 to May 2016.The clinical data were collected,such as name,gender,age,delay time,the US National Institutes of Health Stroke Scale(NIHSS)score,past medical history,examination results in the hospital,discharge diagnosis,TOAST type,therapy in the hospital,as well as hyperbaric oxygen therapy’s start time,frequency,adverse reaction and so on.2.In 3 and 6 months after stroke attack,all patients were completed follow-up that include the main treatment out of hospital,relapse of stroke,died or not,disability or not(considered patients disability on mRS>2,considered patients non disability on mRS≤2).Disability and death were concerned as bad outcome.3.EXCEL software was used to organize and summarize a primary date.And SPSS 17.0 statistical softwarewas used to data analysis.The measured data with normal distribution were expressed by mean ± standard(x ±s).The measured data that didn’t conform to the normal distribution were described as median ± interquartile(M±q25~q75).The count data was represented by the constituent ratio.Multivariate logistic regression analysis was performed to screen the factors based on the analysis of the single parameters,objective and reference.P<0.05 means differences are statistically significant.Result:1.In 3 months after stroke attack,a total of 112 patients had been followed up.Multivariate logistic regression analysis showed that high NIHSS score and intracranial artery stenosis were independent risk factors to prognostic.There was no statistical significance in the effect of prognosis of hyperbaric oxygen therapy for stroke among two groups,But early to start hyperbaric oxygen therapy(≤ 7 days after stroke attack)was benefit for the better prognosis significantly.Poor compliance after discharge was not a significant risk factor to prognosis in multivariate logistic regression analysis,but P was closed to 0.05.2.There were 117 patients had been followed up in 6 months after stroke attack.The results of logistic regression analysis showed that higher NIHSS score and poor compliance after discharge were independent risk factors for the prognosis of patients in 6 months after sick.No statistical difference existed about the better prognosis with hyperbaric oxygen therapy in 6 months follow up.Similarly,early hyperbaric oxygen therapy was nearly a protective factor for prognosis,P closed to 0.05,(P=0.08).There was no significant influence of intracranial artery stenosis for the prognosis in 6 months follow-up.3.No serious adverse events or deaths was observed during the treatment of hyperbaric oxygen for ischemic stroke.However,because of the small number of patients,the factor of course of hyperbaric oxygen didn’t bring into the multivariate logistic regression analysis.The effect of hyperbaric oxygen therapy on recurrence and mortality was not compared with contral group because of baseline data incomparable.Conclusion:1.Earlier(≤7 days after sick)to start the hyperbaric oxygen therapy for ischemic stroke was significantly benefit for the prognosis in 3 months follow-up,and possiblelly benefit in 6 months follow-up.The Hyperbaric oxygen therapeutic effect in patients with cerebral infarction at convalescence and the affect on prognosis of hyperbaric oxygen course need further study.2.The multicentre large sample study was desired to establish to research that hyperbaric oxygen therapy influence the rate of recurrence and mortality.3.Hyperbaric oxygen is a safety treatment for ischemic stroke.