早期高压氧治疗对中重型颅脑损伤患者临床预后及血清NSE,S100B的影响  

Effect of early hyperbaric oxygen therapy on the clinical prognosis of patients with moderate to severe brain injury and their serum NSE,S100B

作　　者：邱治春[1] 王恩任[1] QIU Zhichun;WANG Enren(Department of Neurosurgery,the First Affiliated Hospital of Chengdu Medical College,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：《临床外科杂志》2018年第7期504-506,共3页Journal of Clinical Surgery

摘　　要：目的探讨早期高压氧治疗对中重型颅脑损伤患者临床预后及血清NSE,S100B的影响。方法脑外伤病人131例,按治疗方式不同分成两组,对照组(54例)接受常规治疗,观察组(77例)接受常规联合高压氧治疗。于治疗前,治疗3天,14天,30天给予格拉斯哥损伤评分(GCS);于治疗前和治疗14天和30天检测病人血清中NSE和S100B水平;治疗90天和1年采用格拉斯哥预后评分(GOS)评估病人恢复情况。结果治疗3天,14天,30天后,观察组病人的GCS评分较治疗前时升高(P<0.05);治疗14天,30天后,观察组恢复明显优于对照组,GCS评分比较差异有统计学意义(P<0.05);治疗前两组病人NSE和S100B浓度无明显差异(P>0.05);治疗14天,30天后,两组血清中NSE和S100B浓度均较治疗前明显降低(P<0.05),且观察组病人的NSE和S100B浓度明显低于对照组,差异有统计学意义(P<0.05);90天和1年随访发现,观察组病人GOS优于对照组,两组比较差异有统计学意义(P<0.05);未见明显不良反应发生。结论早期高压氧治疗可有效改善中重度颅脑外伤病人的短期和长期预后,降低病人外周血中NSE和S100B的表达水平。Objective To explore the effect of early hyperbaric oxygen therapy on the clinical prognosis of patients with moderate to severe brain injury and their serum NSE and S100 B. Methods 131 patients with brain trauma were grouped according treatment methods. The control group（ 54 cases） received routine treatment,and the observation group（ 77 cases） received conventional treatment combined with hyperbaric oxygen therapy. The neurological function recovery of the patients were evaluated by GCS score before treatment and on the 3 rd,14 th,and 30 th days of treatment. The serum levels of NSE and S100 B were measured before treatment and on the 14 th and 30 th days after treatment. GOS scores were used to assess patient recovery at 90 days and 1 year after treatment. Results After 3 days,14 days,30 days of treatment,the patients ＇ GCS score of observation group were higher than that at admission（ P〉0. 05）. After 14 days,30 days of treatment,the recovery condition of the observation group was significantly better than that of the control group,with statistical differences（ P〈0. 05）. Before treatment,there were no significantly difference in the concentrations of NSE and S100 B between two groups of patients（ P〈0. 05）. After 14 days,30 days of treatment,the concentrations of NSE and S100 B of two groups of patients were significantly decreased（ P〈0. 05）,and the concentrations of NSE and S100 B in the observation group were significantly lower than those in the control group,with statistical differences（ P〈0. 05）. At 90 days and 1 year follow-up,the GOS score of the observation group was significantly better than that of the control group. There was a statistically significant difference between the two groups（ P〈0. 05）. There was no obvious adverse reaction in hyperbaric oxygen therapy. Conclusion Early hyperbaric oxygen therapy can effectively improve the short-term and long-term prognosis of patients with moderate to severe craniocerebral trauma and effectively reduce the exp

关 键 词：高压氧 脑外伤 NSE S100B 

分 类 号：R651.15[医药卫生—外科学]