阶梯式减压术联合高压氧对重型颅脑损伤患者的近期预后影响  

Effects of multistep decompression combined with hyperbaric oxygen on the short-term prognosis of patients with severe craniocerebral trauma

作　　者：李俊丽 丁圆 韩芸 LI Junli;DING Yuan;HAN Yun(People＇ s Hospital of Taihe County,Anhui,Taihe 236600,China)

机构地区：[1]安徽省太和县人民医院,236600

出　　处：《河北医药》2018年第13期2036-2038,2044,共4页Hebei Medical Journal

摘　　要：目的探讨阶梯式减压术联合高压氧对重型颅脑损伤患者近期预后的影响。方法选择收治的重型颅脑损伤患者67例,按照随机数字表法分为2组:对照组31例给予阶梯式减压术治疗,观察组36例阶梯式减压术联合高压氧治疗。比较2组患者的疗效、术后并发症发生率、双侧大脑中动脉血流动力学及氧化应激反应。结果术后6个月,观察组疗效明显优于对照组,差异有统计学意义(P<0.05);2组患者术后并发症发生率比较差异均无统计学意义(P>0.05);术后48 h,观察组双侧大脑中动脉平均血流速度(Vmean)、收缩期最大血流速度(Vmax)均高于对照组,搏动指数(Pulsed index,PI)明显低于对照组,差异均有统计学意义(P<0.05);术后2周,观察组血清丙二醛明显低于对照组,血清超氧化物岐化酶水平明显高于对照组,差异均有统计学意义(P<0.05)。结论阶梯式减压术联合高压氧治疗显著改善了重型颅脑损伤近期预后及术后双侧大脑中动脉血流动力学,减轻了氧化应激反应,值得临床推广应用。Objective To investigate the effects of multistep decompression combined with hyperbaric oxygen on the short-term prognosis of patients with severe craniocerebral trauma. Methods A total of 67 patients with severe craniocerebral trauma who were treated in our hospital from January 2013 to August 2016 were enrolled in the study. According to random number table method,these patients were divided into control group（ n = 31） and observation group（ n = 36）. The patients in control group were treated by multistep decompression,however,the patients in observation group were treated by multistep decompression combined with hyperbaric oxygen. The clinical curatice effects,incidence rate of postoperative complications,oxidative stress reactions and bilateral middle cerebral artery hemodynamics were observed and compared between the two groups. Results At 6 months after operation,the clinical curatice effects in observation group were superior to those in control group（ P〈0. 05）. There was no significant difference in the incidence rate of postoperative complications between the two groups（ P〈0. 05）. Moreover the bilateral middle cerebral artery mean blood flow velocity（ Vmean） and maximal systolic blood flow velocity（ Vmax） at 48 hours after operation in observation group were significantly higher than those in control group,however pulsatility index（ PI） was significantly lower than that in control group（ P〈0. 05）. In addition,the serum levels of malondialdehyde（ MDA） at 2 weeks after operation in observation group were significantly lower than those in control group,however,the serum levels of superoxide dismutase（ SOD） were significantly higher than those in control group（ P〈0. 05）. Conclusion The multistep decompression combined with hyperbaric oxygen can obviously improve short-term prognosis and bilateral middle cerebral artery hemodynamics of patients with severe craniocerebral trauma,which can alleviate oxidative stress reaction,thus,which should be paid much att

关 键 词：重型颅脑损伤 高压氧 阶梯式减压术 近期预后 

分 类 号：R742.82[医药卫生—神经病学与精神病学]