重症颅脑损伤昏迷患者早期高压氧治疗的促醒作用研究  

Clinical study on early hyperbaric oxygen(HBO)therapy for promoting consciousness in comatose patients with severe brain injury

作　　者：张洁[1] Zhang Jie(Hyperbaric Medicine Center of Rehabilitation Medicine Department,the First Afiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院康复医学科高压氧治疗中心,郑州450000

出　　处：《临床医学》2023年第9期9-12,共4页Clinical Medicine

基　　金：河南省高等学校重点科研项目计划(22A320073)。

摘　　要：目的探讨早期高压氧(HBO)治疗重症颅脑损伤(SCI)昏迷患者对其促醒的效果。方法选取2020年1月至2022年6月郑州大学第一附属医院收治的149例SCI昏迷患者为研究对象。根据入组先后顺序分为对照组(n=74)与观察组(n=75)。对照组给予常规治疗,观察组给予常规治疗+早期HBO。比较两组治疗效果、水肿情况、促醒情况、神经功能缺损情况。结果治疗后,观察组治疗效果(93.33%,70/75)与对照组(82.43%,61/74)比较,差异有统计学意义(χ^(2)=4.167,P=0.041<0.05)。观察组不同脑水肿持续时间例数、平均持续时间与对照组比较,差异有统计学意义(P<0.05)。治疗前,两组格拉斯哥昏迷量表(GCS)评分比较差异未见统计学意义(P>0.05);治疗后,不同时点观察组GCS评分高于对照组(P<0.05)。治疗前,两组美国国立卫生院神经功能缺损量表(NIHSS)评分比较差异未见统计学意义(P>0.05);治疗后,不同时点,观察组NIHSS评分低于对照组(P<0.05)。结论SCI昏迷患者在常规治疗基础上加早期HBO治疗,能提高促醒效果,缩短患者水肿持续时间,而且可改善患者的神经功能缺损症状。Objective To investigate the effect of early hyperbaric oxygen(HBO)treatment on promoting consciousness in coma patients with severe craniocerebral injury(SCI).Methods A total of 149 SCI coma patients admitted to the First Affiliated Hospital of Zhengzhou University from January 2020 to June 2022 were selected as the study subjects.According to the order of enrollment,they were divided into a control group(n=74)and an observation group(n=75).The control group received routine treatment,while the observation group received routine treatment plus early HBO.The treatment effects,edema,wakefulness,and neurological deficits between the two groups were compared.Results After treatment,there was significant difference in the treatment effect between the observation group(93.33%,70/75)and the control group(82.43%,61/74)(x?=4.167,P=0.041<0.05).The number of different brain edema duration and average duration of brain edema in the observation group were significantly different compared to the control group(P<0.05).Before treatment,there was no significant difference in the Glasgow Coma Score(CCS score)between the two groups(P>0.05).After treatment,at different time points,the GCS scores of the observation group were higher than that of the control group(P<0.05).Before treatment,there was no significant difference in the National Institutes of Health Neurological Impairment Scale(NIHSS score)between the two groups(P>0.05).After treatment,at different time points,the NIHSS score of the observation group was lower than that of the control group(P<0.05).Conclusions Early HBO therapy on the basis of routine therapy can improve the effect of arousal,shorten the duration of edema and improve the symptoms of neurological deficits in SCI comatose patients.

关 键 词：重症颅脑损伤 昏迷 早期高压氧 促醒效果 

分 类 号：R651.15[医药卫生—外科学]