高压氧治疗时机和疗程对颅脑损伤疗效的影响

The influences of timing and treatment session of hyperbaric oxygen therapy for traumatic brain injury on the therapeutic effect

目的观察高压氧治疗颅脑损伤的时机和疗程,分析其对疗效的影响。方法对105例颅脑损伤病人和95例颅脑损伤后偏瘫病人,实施高压氧治疗。分析不同时机和疗程的高压氧治疗后,颅脑损伤病人格拉斯哥昏迷量表(GCS)和日常生活活动(ADL)评分的改善情况。结果105例颅脑损伤病人中,1个月内开始行高压氧治疗者GCS评分提高(4.79±2.64),1个月后开始行高压氧治疗者提高(3.00±2.34);治疗50次以上者GCS评分提高(5.03±2.95),50次以下者提高(3.32±2.27)。96例颅脑损伤后偏瘫病人中,伤后1个月内开始高压氧治疗者ADL平均为(72.33±12.22),1个月后开始治疗者为(64.90±11.21);治疗疗程少于20次者治疗后ADL平均为(61.66±11.80),疗程多于20次者为(73.48±10.74)。结论为提高高压氧治疗颅脑损伤的效果,应尽早开始治疗,意识障碍的病人治疗不应少于30次,肢体功能者疗程不少于20次。

Objectives To observe the timing and treatment session of hyperbaric oxygen therapy （HBOT） for traumatic brain injury （TBI） and analyze their influence on the therapeutic effect. Methods One hundred and five patients with traumatic brain injury and 95 with hemiplegia after TBI were treated by HBOT and the time at which they received the treatment and ameliorations of Glasgow coma scale （GCS） and ability to perform activities of daily living （ADL） in these patients were analyzed. Results In the 105 TBI patients with conscious disturbance, GCS score was increased by 4.79 ± 2.64 in those who received HBOT in 30 days, and by 3.00 ± 2.34 in those after 30 days. In the patients who received the therapy more than 50 times, the score was increased by 5.03 ± 2.95, which was more than that （3.32 ± 2.27） Of the patients whose treatment number was less than 50 times. In the 96 patients with hemiplegia after TBI, the mean ADL score was 72.33 ± 12.22 in the patients who received HBOT in 30 days after TBI, and 64.90 ± 11.21 in those who received HBOT after one month. The mean ADL score was 61.66 ± 11.80 in the patients who shared less than 20 treatment sessions and 73.48 ± 10.74 in those with more than 20 treatment sessions. Conclusion HBOT should be initiated as early as possible. The course of HBOT should be not less than 30 times in patients with conscious disturbance, and not less than 20 times in patients for limb function.