高压氧对重型颅脑损伤患者术后脑代谢和脑血流及颅内压的影响  

The effects of hyperbaric oxygen therapy on postoperative brain metabolism,brain blood and intracranial pressure of patients with severe traumatic brain injury

作　　者：王晓[1] 刘建红 

机构地区：[1]解放军89医院神经外科,山东潍坊261021 [2]潍坊军分区第四干休所

出　　处：《实用医药杂志》2016年第4期295-297,304,共4页Practical Journal of Medicine & Pharmacy

摘　　要：目的研究高压氧对重型颅脑损伤患者脑代谢、脑血流及颅内压的影响。方法选取笔者所在医院救治的行血肿清除术+去骨瓣减压术的患者100例,随机分为对照组和高压氧治疗组,每组50例,所有患者均接受相同的常规治疗,高压氧治疗组在常规治疗的基础上给予高压氧治疗4个疗程,对照组除常规治疗外不接受其他治疗。分析统计两组患者在治疗1、3、5和10 d后脑血流动力学参数、颅内压及脑组织氧摄取率的变化,比较两组患者的总体有效率。结果两组患者在治疗1 d后脑血流参数(Vs、Vm、PI值)、颅内压及脑组织氧摄取率无明显差异(P>0.05);治疗3、5、10 d后,高压氧治疗组脑血流动力学参数(Vs、Vm)、脑组织氧摄取率明显高度对照组(P<0.05),而PI值、颅内压明显低于对照组(P<0.05);高压氧治疗组的总体有效率为90.0%,明显高于对照组68.0%,差异有统计学意义(P<0.05)。结论高压氧治疗重型颅脑损伤患者,能够有效改善患者脑血流参数、降低颅内压、增加脑组织氧摄取率,提高治疗的总体有效率,值得推广。Objective To evaluate the effects of hyperbaric oxygen therapy on brain metabolism,brain blood and intracranial pressure of patients with severe traumatic brain injury. Methods The 100 patients with this disease received the surgery for hematoma elimination and decompressive craniectomy in author＇s hospital were randomly divided into two groups：the controlled group and trial group,for each,50 cases. All patients of both groups received the same basic treatment,hematoma elimination and decompressive craniectomy,based on which trial group got additional hyperbaric oxygen therapy. The indexes of brain metabolism,brain blood and intracranial pressure of patients were collected and analyzed at 1 d,3 d,5 d,10 d after above treatment. Results At 1 d,the indexes of brain metabolism,brain blood（Vs,Vm,PI） and intracranial pressure showed no differences between the two groups（P〉0.05）,but there exists significant differences of the indexes of brain metabolism,brain blood（Vs,Vm）and intracranial pressure at 3 d,5 d,10 d（P〈0.05）. The total effective rate of the group received hyperbaric oxygen therapy was higher than that in the control group（P〈0.05）. Conclusion Hyperbaric oxygen therapy as the additional treatment is effective in the improvement of brain metabolism,brain blood and intracranial pressure,and with increasing the total therapeutic rate in patients with severe traumatic brain injury.

关 键 词：高压氧 重型颅脑损伤 脑代谢 脑血流 颅内压 

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