高压氧联合亚低温治疗重型颅脑损伤的临床研究  

Effect of Hyperbaric Oxygen Combined with Mild Hypothermia on Patients with Severe Craniocerebral Injury

作　　者：冯爱琼[1] 曾少霞[1] 覃丽红[1] 

机构地区：[1]肇庆市第一人民医院高压氧室,广东肇庆市526021

出　　处：《中国康复理论与实践》2006年第2期148-149,共2页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的初步探讨高压氧联合亚低温治疗重型颅脑损伤的可行性和疗效。方法选择80例重型颅脑损伤患者随机分为亚低温治疗组(n=52)和对照组(n=28);对照组接受常规综合治疗,亚低温治疗组在此基础上行早期高压氧联合亚低温治疗。治疗前后行经颅多普勒超声(TCD)检测患者大脑中动脉(MCA)收缩期平均血液流速(Vm)、血液流速(Vs)和搏动指数(PI)的变化,同时检测血浆内皮素(ET)的变化,并分析患者的预后。结果治疗后,亚低温治疗组患者MCA的Vm、Vs及PI均有下降,Vs及PI与对照组比较有非常显著性差异(P<0.01),而且ET值明显下降,与同期对照组比较亦有非常显著性差异(P<0.01),临床格拉斯哥昏迷量表(GCS)评分及预后的格拉斯哥结局量表(GOS)分级明显优于对照组。结论高压氧能明显缓解原发脑损伤导致的脑血管痉挛,减轻脑组织的缺血、缺氧状况,降低颅内压,改善伤者的预后。Objective To explore the feasibility and efficacy of hyperbaric oxygen （HBO） therapy combined with mild hypot hermi on severe cranioeerebral injury （SCI）. Methods All 80 SCI patients were randomly divided into therapeutic group （52 cases） and control group （28 eases）. All patients received general synthesis treatment; while the hyperbaric oxygen combined with mild hypothermia treatment was added to the therapeutic group. Changes of Vm, Vs and PI of middle cerebral artery （MCA） in systolic stage were detected by transcranial-Doppler （TCD） before and after treatment. The plasma level of endothelin （ET） was also tested and prognosis of patients was analyzed, Results Vm, Vs and PI of MCA in systolic stage improved obviously and ET reduced greatly in therapeutic group compared with those in the control group （ P 〈50.01）, and prognosis was also superior to control group, Conclusion Hyperbaric oxygen combined with mild hypothermia can improve the consciousness state and prognosis of SCI patients as a result of the relaxation of the cerebral vascular spasm and the reduction of ET, which may contribute to the abatement of the cerebral isehemia and hypoxia.

关 键 词：高压氧 重型颅脑损伤 内皮素 多普勒超声 亚低温治疗 

分 类 号：R651.1[医药卫生—外科学] R459.6[医药卫生—临床医学]