重度脑挫裂伤患者术后早期高压氧治疗疗效观察

Early treatment of patients with severe cerebral contusion by using hyperbaric oxygen after craniotomy

目的探讨重度脑外伤患者早期高压氧治疗的临床效果。方法重度脑挫裂伤患者56例，入院时患者的格拉氏哥评分（glasgow coma scale，GCS）为3～8分，均于入院1h内行去骨瓣减压术或同时行血肿清除术；20例在伤后5～20h内行早期高压氧（HBO）治疗，36例在脑水肿消退后（7～18d）行常规HBO治疗。两组均治疗2个疗程。观察3周后重新GCS评分，6个月后进行格拉氏哥结果评级（glasgow outcome scale，GOS）。结果两组患者治疗后3周GCS评分和6个月后GOS评分差异具有统计学意义。早期HBO治疗组明显优于常规HBO治疗组。结论早期的HBO治疗可以及时提高血氧含量，阻止恶性缺血缺氧的发生。重度脑挫裂伤患者术后在可能的条件下应尽早行HBO治疗，以提高患者的生存质量。

Objective To study the effectiveness of hyperbaric oxygen（HBO）treatment on severe brain contusion patients after traumatic head injury. Methods For 56 cases;of severe brain contusion patients with GCS of 3-8, all bone flaps were removed or hematoma evacuation done at the same time within one hour at admission. HBO treatment was given within 5- 20 hours to 20 cases, while the other 36 cases were given HBO treatment after subsidence of brain edema （7-18 days）. Results Obviously differences were seen between the two groups in GCS after 3 weeks and GOS after6 months. Conclusion Earlier HBO treatment can enhance the oxygen saturation in blood to block the malicious cycle of brain hypoxia,and toincrease the clinical cure rate.