重型颅脑损伤患者早期高压氧辅助治疗的效果观察  

Effect of early hyperbaric oxygen therapy in treating patients with severe craniocerebral trauma

作　　者：朝博[1] 塔娜[1] 苏恩博尔 朱学河 张志超[2] CHAO Bo;TA Na;SUN Born;ZHU Xue-he;ZHANG Zhi-chao(Department of Neurosurgery,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China;Department of Emergency Surgery,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学附属医院神经外科,呼和浩特010050 [2]内蒙古医科大学附属医院急诊外科,呼和浩特010050

出　　处：《创伤外科杂志》2020年第5期336-339,344,共5页Journal of Traumatic Surgery

摘　　要：目的探讨重型颅脑损伤患者早期高压氧辅助治疗的效果。方法回顾性分析2016年6月-2018年9月内蒙古医科大学附属医院收治的重型颅脑损伤患者90例,根据治疗方案不同分为常规组和高压氧组,各45例。常规组男性25例,女性20例;年龄28~59岁,平均42.1岁;术后采取常规康复治疗。高压氧组男性24例,女性21例;年龄31~60岁,平均43.9岁;术后采用高压氧辅助治疗。比较两组患者治疗2个疗程(10d为1个周期)后的经颅超声多普勒(transcranial doppler,TCD)脑血流值、意识水平(GCS评分)、神经功能[(卒中量表:美国国立卫生院神经功能缺损评分(NIHSS)],并比较两组的疗效。结果高压氧组疗效优于常规组;两组脑血流量均较治疗前下降,高压氧组(60.25±4.13)cm/s下降更显著(P<0.05);治疗2个疗程后高压氧组GCS评分(12.25±3.13)分显著高于常规组(9.51±2.03)分(P<0.05);高压氧组死亡和植物状态比例(4.44%)更低(P<0.05);两组治疗2个疗程后NIHSS评分均有所下降(P>0.05),但高压氧组(10.25±4.53)分下降更显著(P<0.05)。结论高压氧辅助传统治疗方法治疗重型颅脑损伤患者效果优于常规治疗方法。Objective To study the effect of early hyperbaric oxygen therapy in patients with severe traumatic brain injury.Methods A retrospective analysis was conducted in 90 patients with severe craniocerebral injury who were admitted to the Affiliated Hospital of Inner Mongolia Medical University from Jun.2016 to Sep.2018.These patients were divided into two groups according to different treatment plans,including 45 patients in the conventional group and 45 patients in the hyperbaric oxygen group.In the conventional group,there were 25 males and20 females,with an average of 42.1 years(range,28 to 59 years).Routine postoperative rehabilitation treatment was performed.In the hyperbaric oxygen group,there were 24 males and 21 females,with an average of 43.9 years(range,31 to 60 years).Hyperbaric oxygen adjuvant therapy was conducted postoperatively.The transcranial doppler(TCD)cerebral blood flow value,consciousness level(GCS score),and neurological function[National Institute of Health Stroke Scale(NIHSS)]of the two groups were compared after 2 courses of treatment(10 days as 1 cycle).Also,the therapeutic effect of the two groups was compared.Results The curative effect of the hyperbaric oxygen group was better than that of the conventional group.The cerebral blood flow in both groups was lower than before treatment,and the hyperbaric oxygen group(60.25±4.13)cm/s decreased more significantly(P<0.05).After two courses of treatment,the GCS score of the hyperbaric oxygen group(12.25±3.13)was significantly higher than that of the conventional group(9.51±2.03,P<0.05);the death and plant state ratio(4.44%)was lower in the hyperbaric oxygen group(P<0.05);NIHSS was decreased after 2 courses of treatment in both groups(P>0.05),but the decrease was more significant in the hyperbaric oxygen group(10.25±4.53,P<0.05).Conclusion Hyperbaric oxygen assisted traditional treatment is better than conventional treatment in patients with severe traumatic brain injury.

关 键 词：颅脑损伤 高压氧 神经功能 

分 类 号：R651.1[医药卫生—外科学]