高压氧联合治疗在脑卒中后认知障碍康复中的应用OA

Post-stroke cognitive impairment(PSCI)is one of the most common sequelae of stroke,which severely compromis-es patients'functional independence,social participation and quality of life.Hyperbaric oxygen(HBO)therapy,which delivers pure oxygen or high-concentration oxygen via inhalation,exerts neuroprotective effects and has been proven effective in improving cogni-tive function.This narrative review summarizes the core mechanisms,treatment regimen selection,combined therapy applications,and potential adverse reactions of HBO therapy for PSCI,aiming to provide references for the clinical management of HBO therapy for PSCI.(1)Core mechanisms:HBO therapy reduces ischemic lesion volume by restoring oxygen supply to ischemic brain tissue,alleviates tight junction injury to maintain blood-brain barrier integrity,regulates oxidation-antioxidation balance to reduce oxidative stress,modulates the cell apoptosis-defense axis to prevent cell death,upregulates hypoxia-inducible factor-1α and neurotrophic fac-tors to promote neurogenesis and angiogenesis,and attenuates neuroinflammation the action of competitive endogenous RNAs.(2)Treatment regimen selection:standard therapeutic pressure is commonly set to 2.0,2.5 or 3.0 atmospheres absolute(ATA),with a single session duration ranging from 1 to 1.5 hours.For the acute phase of ischemic stroke(IS),the recommended regimen is 2.0 ATA for one hour per session,for a total of 60 to 70 sessions;for the chronic phase of IS,the recommended regimen is 2.0 ATA for 1.5 hour per session,for a total of 40 to 60 sessions.For the acute phase of hemorrhagic stroke(HS),the recommended regimen is 2.0 to 2.5 ATA for one hour per session,for a total of 10 to 30 sessions;for the chronic phase of HS,the recommended regimen is 2.0 ATA for 1.5 hour per session,for a total of 40 to 60 sessions.(3)Applications of HBO combination therapy:HBO can be combined with repetitive transcranial magnetic stimulation,transcranial direct current stimulation,acupuncture,cerebellar fastigial nucleus electrical stimulation,music therapy,computerized cognitive training,aerobic exercise,and pharmacological interventions to syner-gize therapeutic effects.(4)Adverse reactions:the incidence of adverse reactions correlates with treatment parameters.Adverse reac-tions are rare when therapeutic pressure is maintained at≤3 ATA.Under standard therapeutic parameters,mild adverse events such as ear discomfort are occasionally reported;pressure exceeding 5 ATA may trigger severe adverse events including agitation and seizure.