高压氧综合救治颅脑损伤的治疗策略及转化研究

Analysis of therapy strategy and translational research about hyperbaric oxygen therapy on craniocerebral injury

目的探讨高压氧综合救治颅脑损伤患者的治疗策略。方法对进行高压氧治疗的875例颅脑损伤患者的疗效及并发症进行回顾性分析。患者入院后由治疗小组制定药物治疗、高压氧治疗、康复计划,确定护理重点并判断预后。分别以"首次高压氧治疗时的昏迷程度,高压氧治疗时是否已行气管切开手术,开始高压氧治疗的时间"为分组条件,比较不同组患者之间的有效率。结果格拉斯哥昏迷评分<9分患者的有效率为60.68%,与其他组比较最低(P<0.05);气管切开术后患者的有效率为48.02%,与对照组比较差异有统计学意义(P<0.001);首次高压氧治疗距离外伤时间<1个月的患者有效率为88.40%,与其他组比较最高(P<0.01)。出现并发症后及时处置。结论以高压氧治疗为主的综合治疗改善了颅脑损伤患者的预后。

Objective To investigate the therapy strategy about hyperbaric oxygen（HBO）therapy on craniocerebral injury patients.Methods Eight hundred seventy five craniocerebral injury patients who were given HBO therapy were analyzed retrospectively.Every patient was treated by a medical team,including medication,HBO treatment,rehabilitative treatment and nursing care.The degree of coma,incision of trachea and beginning time of HBO were regarded as grouping qualifications respectively.Effective rates of patients from different groups were compared respectively.Results The effective rate of patients from Glasgow coma scale（GCS）9 group was 60.68%,which was the lowest（P〈0.012） compared with other groups.The effective rate of patients after incision of trachea was 48.02%,which was significantly lower（P〈0.001） compared with the control group.The beginning time of HBO for some patients′ was less than one month after injury.Their effective rate was 88.40%,which was the highest（P〈0.07） compared with other groups.Some patients with complications were treated in time.Conclusion HBO treatment and synthetic therapies could markedly improve prognosis of craniocerebral injury.