高压氧疗法对重型颅脑损伤患者的疗效及对血清白介素-1β和白介素-6水平的影响

Therapeutic effect of hyperbaric oxygen therapy on patients with severe craniocerebral injury and its influence ;on serum interleukin -1 beta and interleukin -6 levels

目的：探索高压氧疗法用于重型颅脑损伤的临床疗效及对患者血清白介素-1β（IL-1β）、白介素-6（IL-6）水平的影响。方法选择150例重型颅脑损伤患者为研究病例，采用随机、单盲法将其分作两组。对照组75例患者采取常规对症治疗，观察组75例患者在常规对症治疗基础上实施高压氧治疗。对比两组临床疗效。结果观察组总有效率为94．67％，显著高于对照组的77．33％，差异有统计学意义（χ2＝7．83，P ＜0.05）。治疗前两组 GCS 和 ADL 评分比较，差异均无统计学意义（t ＝1．22、2．39，均 P ＞0．05）。治疗后观察组的 GCS 和 ADL 评分分别为（12．18±2．13）分、（67．46±12．55）分，均明显高于治疗前（t ＝8．01、7．76，均 P ＜0.05），且与对照组比较差异均有统计学意义（t ＝7．23、6．82，均 P ＜0．05）。治疗前两组血清 IL-1β和 IL-6水平比较，差异均无统计学意义（t ＝2．10、1．01，均 P ＞0．05）。治疗后观察组血清 IL-1β和 IL-6水平分别为（127．48±16．35）pg／mL、（89．66±13．47）pg／mL，均明显低于治疗前（t ＝8．34、7．89，均 P ＜0．05），且与对照组差异均有统计学意义（t ＝7．65、7．22，均 P ＜0．05）。结论重型颅脑损伤患者于常规对症治疗基础上实施高压氧治疗，能够有效改善其临床症状和体征，降低血清 IL-1β、IL-6水平，促进脑功能及日常生活能力恢复，值得临床借鉴和推广。

Objective To explore the clinical curative effect of hyperbaric oxygen therapy for severe cranio-cerebral injury,and its influence on the level of serum interleukin -1 beta（IL -1 ）and interleukin -6（IL -6）. Methods 150 patients with severe craniocerebral injury were selected and divided into two groups by random and single blind method.75 patients of the control group were treated with conventional therapy,75 patients of the observation group were given hyperbaric oxygen on the basis of the conventional treatment,and the clinical efficacy was compared between the two groups.Results The total effective rate of the observation group was 94.67%,which was significantly higher than 77.33% of the control group,the difference was statistically significant（χ2 =7.83,P 〈0.05）.There were no significant differences in GCS and ADL scores between the two groups（t =1.22,2.39,all P 〉0.05）.After treat-ment,the GCS and ADL scores of the observation group were （12.18 ±2.13）points,（67.46 ±12.55）points,which were significantly higher than those before treatment（t =8.01,7.76,all P 〈0.05）,and there were significant differ-ences between the two groups（t =7.23,6.82,all P 〈0.05）.Before treatment,there were no significant differences in the serum levels of IL -6 and IL -1 between the two groups（t =2.10,1.01,all P 〉0.05）.After treatment,the serum levels of IL -1 and IL -6 in the observation group were （127.48 ±16.35）pg/mL,（89.66 ±13.47）pg/mL, which were significantly lower than before treatment（t =8.34,7.89,all P 〈0.05）,there were significant differences between the two groups（t =7.65,7.22,all P 〈0.05）.Conclusion Implementation of hyperbaric oxygen in patients with severe traumatic brain injury on the basis of conventional symptomatic treatment can effectively improve the clinicalsymptoms and signs,reduce the serum IL -1 and IL -6 levels,promote the recovery of brain function and ability of daily life,and which is worth to be promoted in clinical.