重症颅脑损伤昏迷患者早期高压氧(HBO)治疗促醒的临床研究  

Clinical study of early hyperbaric oxygen(HBO)therapy for wake-up promotion in comatose patients with severe craniocerebral injury

作　　者：张琪 尹秀玲[1] 罗娟[1] 朱江珍 ZHANG Qi;YIN Xiu-ling;LUO Juan;ZHU Jiang-zhen(Department of Rehabilitation Medicine,the First Affiliated Hospital of Nanchang University,Jiangxi Province,Nanchang330006,China)

机构地区：[1]南昌大学第一附属医院康复医学科,江西南昌330006

出　　处：《中国当代医药》2021年第14期47-49,53,共4页China Modern Medicine

基　　金：江西省卫生计生委科技计划项目(20155191)。

摘　　要：目的探讨重症颅脑损伤昏迷患者早期高压氧(HBO)治疗促醒的临床效果。方法选择2015年1月~2017年12月南昌大学第一附属医院接诊的120例重症颅脑损伤昏迷患者作为研究对象,按照治疗方式不同分为试验组(n=60)和对照组(n=60)。对照组患者行康复促醒治疗,在此基础上,试验组患者给予HBO治疗[A组(n=10):病程≤10 d,HBO治疗1~10次;B组(n=10):病程≤10 d,HBO治疗11~20次;C组(n=10):病程≤10 d,HBO治疗21~30次。D组(n=10):病程11~20 d,HBO治疗1~10次;E组(n=10):病程11~20 d,HBO治疗11~20次;F组(n=10):病程11~20 d,HBO治疗21~30次]。比较各组患者治疗前及治疗后10、20、30 d时格拉斯哥昏迷量表(GCS)评分。结果各组治疗前、治疗后10 d时GSC评分比较,差异无统计学意义(P>0.05);试验组治疗后20、30 d时GSC评分为(9.62±2.68)、(12.48±2.01)分,高于对照组的(7.39±2.14)、(8.05±1.45)分,差异有统计学意义(P<0.05)。试验组病程≤10 d患者中,C组治疗后20、30 d时GSC评分为(13.45±2.32)、(15.20±2.15)分,高于B组的(11.01±2.01)、(12.05±2.01)分,高于A组的(8.95±1.98)、(10.56±1.95)分,差异有统计学意义(P<0.05);病程11~20 d患者中,F组治疗后20、30 d时GSC评分分别为(11.32±1.95)、(12.48±2.37)分,高于E组的(9.01±2.29)、(10.56±1.65)分,高于D组的(7.43±2.05)、(8.12±1.36)分,差异有统计学意义(P<0.05);试验组相同治疗次数中,治疗后20、30 d时,A组的GSC评分高于D组,B组的GSC评分高于E组,C组的GSC评分高于F组,差异有统计学意义(P<0.05)。结论早期HBO治疗重症颅脑损伤昏迷患者促醒效果较好,发病后10 d内是重症颅脑损伤昏迷患者HBO治疗最佳时间窗,治疗以21~30次为宜。Objective To investigate the clinical effect of early hyperbaric oxygen(HBO)therapy for wake-up promotion in comatose patients with severe craniocerebral injury.Methods A total of 120 cases of comatose patients with severe craniocerebral injury admitted to the First Affiliated Hospital of Nanchang University from January 2015 to December 2017 were selected as the research objects,and they were divided into the treatment group(n=60)and the control group(n=60)according to different treatment methods.The control group received traditional rehabilitation treatment for wake-up promotion,and on this basis,the treatment group was given HBO treatment(group A[n=10]:course≤10 days,HBO treatment 1-10 times;group B[n=10]:course≤10 days,HBO treatment 11-20 times;group C[n=10]:course≤10 days,HBO treatment 21-30 times;group D[n=10]:course 11-20 days,HBO treatment 1-10 times;group E[n=10]:course 11-20 days,HBO treatment 11-20 times;group F[n=10]:course 11-20 days,HBO treatment 21-30 times).The Glasgow coma scale(GCS)scores were compared in each group before treatment,at 10,20 and 30 days after treatment.Results There were no statistically significant differences in the GSC scores of each group before treatment and at 10 days after treatment(P>0.05).The GSC scores of the experimental group were(9.62±2.68)and(12.48±2.01)points at 20 and 30 days after treatment,which were higher than the control group′s(7.39±2.14)and(8.05±1.45)points,the differences were statistically significant(P<0.05).Among the patients with disease course≤10 d in the experimental group,the GSC scores in group C were(13.45±2.32)and(15.20±2.15)points at 20 and 30 days after treatment,which were higher than those in group B of(11.01±2.01)and(12.05±2.01)points,also higher than those in group A of(8.95±1.98)and(10.56±1.95)points,the differences were statistically significant(P<0.05).Among patients with disease course from 11 to 20 days,the GSC scores of group F were(11.32±1.95)and(12.48±2.37)points at 20 and 30 days after treatment,which were h

关 键 词：重症颅脑损伤 昏迷 高压氧 促醒 

分 类 号：R595[医药卫生—内科学]