探讨超早期高压氧治疗重型颅脑损伤患者对血清抗脑抗体含量的影响及预后的差别  

Study on Effect of Ultra-early Hyperbaric Oxygenation in Treatment of Severe Patients with Cerebral Injury on the Serum Anti-brain Antibody Content and Difference in Prognosis

作　　者：熊佳宁 宋立坤[1] 孙冲[1] XIONG Jia-ning;SONG Li-kun;SUN Chong(Department of Neurosurgery,Huantai People's Hospital,Huantai,Shandong Province,256400 China)

机构地区：[1]山东省桓台县人民医院神经外科,山东桓台256400

出　　处：《世界复合医学》2018年第5期26-29,共4页World Journal of Complex Medicine

摘　　要：目的探讨超早期高压氧治疗重型颅脑损伤患者对血清抗脑抗体含量的影响及预后的差别。方法总结分析了该院2015年1月—2017年1月182例患者,根据是否采取高压氧治疗及开始时间的不同,将患者分为超早期组(外伤后3 d内开始高压氧治疗)、普通组(外伤后4～10 d内开始高压氧治疗)、对照组(未行高压氧治疗),进行回顾性研究,比较几组之间血清抗脑抗体含量的差别,采用国际通用的格拉斯哥预后评分(GOS)评定,对各组之间预后进行比较。结果超早期组患者伤后1、3、5、7、14、30 d的ABAb浓度分别为(0.523±0.135)U/mL、(1.287±0.226)U/mL、(1.456±0.212)U/mL、(1.551±0.309)U/mL、(1.693±0.324)U/mL、(1.303±0.211)U/mL;普通组患者伤后1、3、5、7、14、30 d的ABAb浓度分别为(0.509±0.146)U/mL、(1.408±0.293)U/mL、(1.511±0.192)U/mL、(1.611±0.298)U/mL、(1.743±0.331)U/mL、(1.358±0.236)U/mL;对照组患者伤后1、3、5、7、14、30 d的ABAb浓度分别为(0.514±0.121)U/mL、(1.412±0.301)U/mL、(1.552±0.221)U/mL、(1.651±0.286)U/mL、(1.796±0.312)U/mL、(1.405±0.205)U/mL。在伤后1 d,各组之间含量差异无统计学意义(F=1.886,P>0.05),伤后3 d,超早期组血清中ABAb浓度明显低于普通组及对照组(t=4.303,3.182,P<0.05),普通组与对照组之间ABAb浓度含量差异无统计学意义(t=1.638,P>0.05)。其余各时间点超早期组血清中ABAb浓度明显低于普通组(t=6.965,4.541,3.365,3.306,2.447,2.365,P<0.05),普通组血清中ABAb浓度明显低于对照组,差异有统计学意义(t=2.776,2.571,2.306,2.262,2.228,2.201,P<0.05)。超早期组预后良好率42.4%(25/59)显著高于普通组31.9%(22/69)(χ~2=11.14,P<0.05),普通组预后良好率31.9%(22/69)显著高于对照组24.1%(13/54)(χ~2=12.83,P<0.05)。结论超早期高压氧治疗重型颅脑损伤,可明显降低血清抗脑抗体含量,改善病人预后。Objective To study the effect of ultra-early hyperbaric oxygenation in treatment of severe patients with cerebral injury on the serum anti brain antibody content and difference in prognosis.Methods 182 cases of patients in our department from January 2015 to January 2017 were summarized and analyzed,and divided into three groups according to whether the hyperbaric oxygen existed or not and starting time,including the ultra-early group(hyperbaric oxygen has begun in 3 d after trauma),common group(hyperbaric oxygen has begun in 4~10 d after trauma),and the control group(hyperbaric oxygen was not conducted),and the difference in the serum anti brain antibody content was compared,and the GOS was used for evaluation,and the prognosis of each group was compared.Results The ABAb concentrations in 1 d,3 d,5 d,7 d,14 d,30 d after wound in the ultra-early group,in the common group and in the control group were respectively(0.523±0.135)U/mL,(1.287±0.226)U/mL,(1.456±0.212)U/mL,(1.551±0.309)U/mL,(1.693±0.324)U/mL,(1.303±0.211)U/mL;(0.509±0.146)U/mL,(1.408±0.293)U/mL,(1.511±0.192)U/mL,(1.611±0.298)U/mL,(1.743±0.331)U/mL,(1.358±0.236)U/mL;(0.514±0.121)U/mL,(1.412±0.301)U/mL,(1.552±0.221)U/mL,(1.651±0.286)U/mL,(1.796±0.312)U/mL,(1.405±0.205)U/mL,and there was no obvious difference between groups in 1d after wound,(F=1.886,P>0.05),and the serum ABAb concentration in the ultra-early group in 3 d after wound was obviously lower than that in the common group and in the control group(t=4.303,3.182,P<0.05),there was no obvious difference in the ABAb concentration content between the common group and the control group(t=1.638,P>0.05),and the serum ABAb concentration in the ultra-early group at various time points was obviously lower than that in the common group(t=6.965,4.541,3.365,3.306,2.447,2.365,P<0.05),the serum ABAb concentration in the common group was obviously lower than that in the control group,and the difference was statistically significant(t=2.776,2.571,2.306,2.262,2.228,2.201,P<0.05),and the prognosis g

关 键 词：颅脑损伤 超早期 高压氧 抗脑抗体 

分 类 号：R651.15[医药卫生—外科学]