标准外伤大骨瓣减压术联合高压氧治疗重型颅脑外伤患者对其血清TFPI-1及尿L-FABP水平的影响  

The effect of standard large trauma bone flap decompression and hyperbaric oxygen therapy on serum TFPI-1 and urine L-FABP level in patients with severe cranio-cerebral trauma

作　　者：邱治春[1] 张列[1] 樊庆荣[1] 何明杰[1] QIU Zhichun,ZHANG Lie,FAN Qingrong,HE Mingjie(Department of Neurosurgery, the First Affiliated Hospital of Chengdu Medical College,Sichuan Province,Chengdu 610500, China)

机构地区：[1]成都医学院第一附属医院神经外科,610500

出　　处：《疑难病杂志》2018年第7期675-678,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察标准外伤大骨瓣减压术联合高压氧治疗重型颅脑外伤患者的疗效及其对其血清组织因子途径抑制物1(TFPI-1)及尿肝型脂肪酸结合蛋白(L-FABP)水平的影响。方法收集2011年6月—2016年6月成都医学院第一附属医院神经外科收治的重型颅脑外伤损伤患者100例,随机信封法分为观察组及对照组各50例。对照组患者采用标准外伤大骨瓣减压术治疗,观察组采用标准外伤大骨瓣减压术联合高压氧治疗。对比分析2组患者预后质量及其对血清TFPI-1、尿L-FABP水平的影响。结果观察组患者清醒率显著高于对照组(χ~2=12.000,P<0.01),病死率显著低于对照组(χ~2=12.278,P<0.01),意识恢复时间显著短于对照组(t=7.416.P<0.01);治疗2个月后观察组患者GCS评分显著高于对照组(t=6.638,P<0.01);随访6个月后观察组患者预后质量显著高于对照组(χ~2=23.894,P<0.01),且观察组患者GOS评分显著高于对照组(t=14.587,P<0.01);治疗后观察组血中TFPI-1及TFPI-1原显著高于对照组(t=6.770,P=0.000;t=6.082,P=0.000);治疗后观察组尿中L-FABP水平显著低于对照组(t=27.671,P<0.05)。结论重型颅脑外伤患者采用标准外伤大骨瓣减压术联合高压氧治疗后可有效提高患者预后质量,改善血清TFPI-1及尿L-FABP水平,具有较好临床应用价值。Objective To analyze the effect of the standard large trauma bone flap decompression and hyperbaric oxygen therapy on the serum TFPI-1 and urinary L-FABP levels in patients with severe cranio-cerebral trauma. Methods From June 2011 to June 2016, 100 cases of patients with severe cranio-cerebral trauma were randomly divided into 2 groups, control group patients received standard large trauma craniotomy, observation group were treated with standard large trauma craniotomy combined with hyperbaric oxygen therapy; effect of the two groups of patients with quality of prognosis and serum TFPI-1 and urinary L-FABP levels were compared. Results The waking rate of the observation group was higher than that of the control group（χ^2= 12. 000,P〈0. 01）,and the mortality rate was lower than that of the control group（χ^2 =12. 278,P〈0.01）,and the recovery time in the observation group was shorter than that of the control group（t = 6. 638,P〈0. 01）, and the GCS score of the observation group was higher than that of the control group（t=7.416,P〈0.01） after 2 months of treatment. After 6 month follow up,the prognosis quality and the GOS score of the observation group was higher than that of the control group（χ^2 =23.894, t = 14. 587,P〈0. 01）,and the serum TFPI-1 and TFPI-1 primary in the observation group were higher than that of the control group（t = 6. 770,P = 0. 000; t = 6. 082,P= 0. 000）. The level of L-FABP was lower than that of the control group（t =27. 671,P〈0. 05）. Conclusion Standard traumatic large trauma decompresion combined with hyperbaric oxygen therapy can effectively improve the prognosis of patients with severe craniocerebral trauma, improve serum TFPI-1 and urine L-FABP levels, and has high clinical value.

关 键 词：标准外伤大骨瓣减压术 高压氧 颅脑外伤 组织因子途径抑制物-1 肝型脂肪酸结合蛋白 

分 类 号：R651.15[医药卫生—外科学]