高压氧在不同治疗时机和疗程中治疗重型颅脑外伤的疗效

Effects of Hyperbaric Oxygen with Different Times and Courses on Severe Traumatic Brain Injury

目的探讨高压氧在不同时机和疗程中治疗重型颅脑外伤的疗效。方法将90例格拉斯哥昏迷评分（GCS）≤8分的重型颅脑脑外伤患者按治疗方法不同分为治疗组（n=65）与对照组（n=25）。2组患者均按常规治疗,治疗组在患者病情稳定后行高压氧治疗,观察开始高压氧治疗的不同时机（T1-T3为伤后15 d内、16~30 d内3、1 d以上）和不同高压氧治疗疗程（C1-C4分别为1、2、3、3个以上疗程）的治愈显效率。结果 2组患者治疗后GCS评分较治疗前均明显升高（P〈0.05）;治疗后治疗组患者GCS评分亦明显高于对照组（P〈0.05）。治疗组T1、T2和T3不同治疗时机间治愈显效率相比,差异均有统计学意义（P〈0.05）;C1与C2、C3与C4治愈显效率相比,差异均无统计学意义（P〉0.05）;C1、C2与C3、C4治愈显效率相比,差异有统计学意义（P〈0.05）。结论早期和持续3个疗程高压氧治疗能改善重型颅脑外伤患者的治愈显效率,是一种行之有效的康复治疗手段。

Objective To investigate the effects of hyperbaric oxygen with different times and courses on severe traumatic brain injury.Methods Ninety patients with severe traumatic brain injury（Glasgow coma scale scores≤8） were divided into treatment group（n=65） and control group（n=25）.All patients were treated with conventional therapy.Additionally,patients in treatment group received different courses of treatment with hyperbaric oxygen（C1：1 course;C2：2 courses;C3：3 courses;C4：more than 3 courses） at different times（T1：within 15 days after injury;T2：16-30 days after injury;T3：31 days or more after injury）.The significant efficiency of cure was observed.Results After treatment,Glasgow coma scale scores significantly increased in both groups（P0.05）,and the scores in treatment group were higher than those in control group（P0.05）.There were significant differences in significant efficiency of cure among patients treated with hyperbaric oxygen at different times（T1,T2 and T3,P0.05）.No obvious differences in significant efficiency of cure were observed between C1 and C2（short course group,P0.05）,as well as between C3 and C4（long course group,P0.05）,but there were significant differences between short course group and long course group（P0.05）.Conclusion Three courses of early and continuous hyperbaric oxygen therapy can improve the significant efficiency of cure,and hence is an effective means for recovery from severe traumatic brain injury.