高压氧对重型颅脑损伤患者脑血流动力学及颅内压的影响研究

Effect of hyperbaric oxygen on patients with severe traumatic brain injury and on intracranial hemodynamics

目的探讨高压氧对重型颅脑损伤患者脑血流动力学及颅内压(ICP)影响。方法采用回顾性分析方法,将解放军第三○九医院2013年1月至2014年1月收治的82例重型颅脑损伤患者,按照1∶1比例分为两组,每组各41例,对照组给予常规治疗,观察组在对照组基础上给予高压氧持续治疗,并对两组患者治疗前后的血流动力学参数及ICP进行比较分析。结果高压氧组患者大脑中动脉收缩期峰流速(Vs)、平均血流速度(Vm)均快于对照组(P<0.05),搏动指数(PI)低于对照组(P<0.05);观察组高压氧治疗后ICP值为(11.20±3.39)mmHg明显低于对照组的(15.24±3.13)mmHg,差异具有统计学意义(P<0.05);且观察组总有效率为85.37%,对照组总有效率为68.29%,明显优于对照组(P<0.05)。结论高压氧早期治疗可明显改善重型颅脑损伤患者的免疫功能,增强危重病患者抵抗感染能力,提高患者治疗效果,全面改善患者的预后及生活质量。

Objective To investigate the effect of hyperbaric oxygen on cerebral hemodynamics and intracranial pressure（ICP）in patients with severe traumatic brain injury （SBI）.Methods A retrospective analysis was conduccted .82 cases of SBI patients treated in our hospital from January 2013 to January 2014 were randomly and evenly divided into two groups.Control group received conventional treatment while observation group was treated with continuous hyperbaric oxygen therapy.Intracranial hemodynamic parameters before and after treatment were determined and compared between the two groups.Results Peak systolic velocity （ Vs） and mean flow velocity （ Vm） of the middle cerebral artery （ MCA） were faster in hyperbaric oxygen group than in control group （P〈0.05）; the pulsatility index was lower than in control group （P〈0.05）;intracranial pressure （ICP） values （11.20 ±3.39）mmHg were significantly lower in observation group after hyperbaric oxygen therapy than in control group （15.24 ±3.13）mmHg.The difference was statistically significant （P〈0.05）, and the total effective rate was 85.37% vs 68.29% in control group（P〈0.05）.Conclusion Early hyperbaric oxygen therapy can significantly enhance SBI patients immune function and the ability to fight against infections in critically ill patients, therefore improving patients outcomes and overall quality of life .