高压氧对重型颅脑损伤患者脑血流动力学、血清NT-proBNP及颅内压的影响  

Effects of hyperbaric oxygen on cerebral hemodynamics, serum NT-proBNP and intracranial pressure in patients with severe head injury

作　　者：刘红梅 

机构地区：[1]阳泉煤业集团总医院康复医学科,山西阳泉045000

出　　处：《中国实用医刊》2017年第13期21-25,共5页Chinese Journal of Practical Medicine

摘　　要：目的 探讨高压氧（HBO）对重型颅脑损伤（STBI）患者脑血流动力学、血清N末端脑钠素前体（NT-proBNP）及颅内压（ICP）的影响.方法 抽取2014年5月至2015年8月收治的STBI患者76例,通过随机数表法分组,每组38例.对照组采用常规治疗措施,研究组在对照组治疗基础上加用HBO治疗,共治疗3个疗程.对比治疗前后两组脑血流动力学[舒张末期血流速度（Vd）、收缩期峰值血流速度（Vs）、平均血流速度（Vm）、阻力指数（RI）、搏动指数（PI）]水平及血清炎性因子[肿瘤坏死因子-α（TNF-α）、C-反应蛋白（CRP）]变化情况,分析治疗前及治疗后不同时间段两组ICP、血清NT-proBNP水平与格拉斯哥昏迷量表（GCS）评分变化情况.结果 ①脑血流动力学：治疗前两组Vd、Vs、Vm、RI、PI水平比较差异未见统计学意义（P〉0.05）,治疗后两组各指标水平均有所改善,且研究组Vd、Vs、Vm速度高于对照组,RI、PI小于对照组,差异有统计学意义（P〈 0.05）;②颅内压：治疗前两组ICP水平比较差异未见统计学意义（P〉0.05）,治疗后研究组ICP水平低于对照组,差异有统计学意义（P＆lt;0.05）;③血清NT-proBNP及炎性因子：治疗前两组血清NT-proBNP、TNF-α、CRP水平比较差异未见统计学意义（P〉0.05）,治疗后两组血清NT-proBNP、TNF-α、CRP水平均较治疗前降低,且研究组低于对照组,差异有统计学意义（P＆lt;0.05）;④意识状态：治疗前两组GCS评分比较差异未见统计学意义（P〉0.05）,治疗后两组GCS评分较治疗前增高,且研究组高于对照组,差异有统计学意义（P＆lt;0.05）.结论 采用高压氧治疗重型颅脑损伤效果显著,可有效改善患者脑血流动力学水平,降低颅内压及血清NT-proBNP与炎性因子水平,恢复患者意识状态.Objective To investigate the effects of hyperbaric oxygen （HBO） on cerebral hemodynamics, serum N-terminal pro-brain natriuretic peptide （NT-proBNP） and intracranial pressure （ICP） in patients with severe craniocerebral injury （STBI）.Methods Seventy-six STBI patients from May 2014 to August 2015 were randomly devided into control group and research group, 38 cases in each group.The control group was treated by routine therapy, and the study group was treated by HBO on the basis of the control group, a total of 3 courses of treatment were performed.End-diastolic blood flow velocity （Vd）, systolic peak velocity （Vs）, mean blood flow velocity （Vm）, resistance index （RI）, pulsatility index （PI）, and the levels of serum inflammatory factors （TNF-α）, C-reactive protein （CRP） were measured before and after treatment.Results Cerebral hemodynamics： there was no significant difference in Vd, Vs, Vm, RI or PI between the two groups before treatment （P〉0.05）, the Vd, Vs and Vm velocity of the study group were significantly higher than those of the control group, RI and PI were significantly lower than those of the control group （P〈 0.05）.Intracranial pressure： there was no significant difference in ICP level between the two groups before treatment （P〉0.05）.The level of ICP in the study group was lower than that in the control group after treatment （P〈 0.05）.Serum NT-proBNP and inflammatory factors： there was no significant difference of NT-proBNP, TNF-α or CRP between the two groups before treatment （P〉0.05）, after treatment, the levels of NT-pro BNP, TNF-α and CRP in the two groups were lower than those before treatment, and the differences were significant （P〈 0.05）.State of consciousness： there was no significant difference in GCS scores between the two groups before treatment （P〉0.05）.The scores of GCS in the two groups were both higher than those before treatment, and the research group was higher than the control group, the

关 键 词：高压氧 重型颅脑损伤 脑血流动力学 血清N末端脑钠素前体 颅内压 

分 类 号：R651.15[医药卫生—外科学]