高压氧对中高海拔地区老年双侧慢性硬膜下血肿术后脑复张的疗效观察  

Therapeutic effect of hyperbaric oxygen on postoperative brain re-expansion in elderly patients with bilateral chronic subdural hematoma at middle and high altitude areas

作　　者：李亚东 线春明[1] 贺喜武[1] 卢忠胜[1] 杨鹏[1] 陈强[1] 曾振林 张强[1] Li Yadong;Xian Chunming;He Xiwu;Lu Zhongsheng;Yang Peng;Chen Qiang;Zeng Zhenlin;Zhang Qiang(Department of Neurosurgery,People Hospital of Qinghai Province,Xining 810007,China)

机构地区：[1]青海省人民医院神经外科,西宁810007

出　　处：《中华神经创伤外科电子杂志》2018年第6期329-332,共4页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

基　　金：青海省基础研究计划项目(2019-ZJ-7040)

摘　　要：目的探讨中高海拔地区高压氧治疗对老年双侧慢性硬膜下血肿(CSDH)钻孔引流术后脑复张的影响。方法选取青海省人民医院神经外科自2010年1月至2017年12月收治的84例双侧CSDH老年患者,按照随机数字表法分为对照组和观察组。对照组:41例患者行双侧穿刺引流术后常规治疗;观察组:43例患者在术后常规治疗的基础上再加用高压氧治疗。根据术后复查头颅CT血肿残腔最大层面的厚度(T),将脑复张程度分为4级(Ⅰ～Ⅳ级)。比较2组患者术后1、2个月脑复张程度的差异。结果术后1个月,2组患者复查头颅CT后测量硬膜下残腔厚度显示,观察组的脑复张程度高于对照组,差异有统计学意义(P=0.002)。术后2个月,2组患者复查头颅CT后测量硬膜下残腔厚度显示,观察组的脑复张程度也高于对照组,差异有统计学意义(P=0.001)。结论高压氧治疗能有效促进中高海拔地区双侧CSDH术后脑复张,可作为中高海拔地区CSDH术后常规辅助治疗措施。Objective To discuss the effect of hyperbaric oxygen （HBO） in elderly patients with postoperative brain re-expansion of bilateral chronic subdural hematoma （CSDH） at middle and high altitude areas. Methods The clinical data of 84 elderly patients, admitted to Department of Neurosurgery, People Hospital of Qinghai Province from Jan 2010 to Dec 2017, with bilateral CSDH living at middle and high altitudes were selected and divided into control group and observation group according to random number table method. Forty-one cases in the control group received routine treatment after bilateral puncture and drainage, while 43 cases in the observation group received hyperbaric oxygen therapy on the basis of routine treatment after operation. According to the maximum thickness （T） of the residual cavity of cranial CT hematoma after operation, the degree of brain re- expansion was divided into 4 grades （I-IV）. The differences of the degree of brain re-expansion were compared between the 2 groups in one month and two months after operation. Results One month after operation, the thickness of the subdural residual cavity measured by the two groups after cranial CT re-expansion showed that the degree of brain re-expansion in the observation group was higher than that in the control group, and the difference was statistically significant （P =0.002）. Two months after operation, the thickness of the subdural residual cavity measured by the two groups after cranial CT re-expansion showed that the degree of brain re-expansion in the observation group was also higher than that in the control group, the difference was statistically significant （P=0.001）. Conclusion HBO therapy can effectively promote postoperative brain re-expansion of bilateral CSDH at middle and high altitude areas. It can be used as a routine auxiliary treatment for CSDH after operation in plateau area.

关 键 词：高压氧 慢性硬膜下血肿 脑复张 

分 类 号：R651.1[医药卫生—外科学]