早期高压氧治疗脑弥漫性轴索损伤35例临床观察

Efficacy observation of early hyperbaric oxygen on treatment on 35 cases of cerebral diffuse axonal injury

目的观察早期高压氧(HBO)治疗脑弥漫性轴索损伤(DAI)的临床疗效,并分析其作用机制。方法DAI患者70例随机分成治疗组及对照组,观察2组清醒人数的平均清醒时间,治疗前后GCS评分变化,治疗6个月后的GOS评分,病死和植物状态的比例,并分析2组的临床疗效。结果治疗组清醒患者的平均觉醒时间较对照组明显缩短(P<0.01)。2组3个疗程后的GCS评分及6个月后的GOS评分比较差异有统计学意义(P<0.01)。治疗组病死率及植物状态比率较对照组低(P<0.05),临床恢复良好率明显高于对照组(P<0.01)。结论早期HBO治疗DAI可明显缩短患者昏迷时间,降低病死及伤残率,促进患者神经功能恢复。

Objective To observe the therapeutic effect of hyperbaric oxygenation （HBO） on cerebral diffuse axonal injury and to analyze its action mechanism.Methods 70 patients with diffuse axonal injury were randomly divided into two groups, HBO treatment group （ n = 35） and control group （ n = 35）. The therapeutic effects including the average awakening time in awaking patients, the changes in GCS, GOS 6 months after treatment, the ratio of vegetative state and mortality were observed and compared for both groups. Results The average awakening time in awaking patients of HBO treatment group was significantly shorter than that of control group （ P 〈 0. 01 ）. There were significantly differences in GCS scores after 3 treatment courses and GOS scores after 6 months between two groups （ P 〈 0. 01 ）, the ratio of vegetative state and mortality in HBO treatment group were significantly lower than those in control group （ P 〈 0.05）. The total effective rate and healing rate in HBO treatment group were significantly higher than those in control group （ P 〈 0.01）. Conclusion Early HBO treatment for cerebral diffuse axonal injury can shorten patients＇ coma time, decrease mortality and disabled rate, and promote the recovery of nerves fimction of patients with cerebral diffuse axonal injury.