不同压力高压氧对颅脑外伤术后昏迷患者的早期治疗

Hyperbaric Oxygen at Different Pressure as Early Treatment for Post-operative Coma of Patients with Cerebral Trauma

目的观察不同压力高压氧(HBO)对颅脑外伤术后昏迷患者的早期疗效。方法按入组先后顺序随机将75例颅脑外伤术后昏迷患者分为对照组、0.20MPa高压氧组(HBO1组)和0.25MPa高压氧组(HBO2组),每组25例,比较三组患者在术后1周内和术后1月的格拉斯哥昏迷评分(GCS),以及出院前的治愈显效率。结果 (1)三组患者在术后1周内GCS评分无统计学差异(P>0.05),但治疗1月后GCS评分均提高(P<0.05)。(2)治疗后HBO1组和HBO2组GCS评分明显高于对照组,且HBO2组评分高于HBO1组(P<0.05)。(3)HBO1组和HBO2组的治愈显效率(76%和80%)明显高于对照组(48%)(P<0.05),但HBO1组和HBO2组之间无统计学差异(P>0.05)。结论早期两种压力的HBO治疗对颅脑外伤术后昏迷患者的恢复均有良好促进作用,其中0.25MPa压力的HBO对患者的促醒作用可能更优。

Objective To observe the curative effect of hyperbaric oxygen （HBO） at different pressure as the early treatment on post-operative coma of patients with cerebral trauma. Methods 75 cases with cerebral trauma suffering from post-operative coma were randomly divided into 3 groups：HBO group 1 （at 0.20MPa）,HBO group 2 （at 0.25MPa） and control group,25 in each;a comparative study was made to the Glasgow coma scores （GCS） of the patients in the 3 groups at 1 week and at 1 month after operation,as well as to the cured and obvious effective rate before discharge. Results There existed no statistical difference among the GCS at 1 week after operation of the patients in the 3 groups （P〉0.05） while their scores all increased at 1 month after operation （P〈0.05）;the scores of HBO group 1 and HBO group 2 were both higher than that of control group after treatment,and the scores of HBO group 2 were higher than that of HBO group 1 （P〈0.05）;the obvious effective rates of HBO group 1 and HBO group 2 （76%and 80%） were significantly higher than that of control group （48%） （P〈0.05） while no statistical difference was found between the rates of HBO group 1 and HBO group 2 （P〉0.05）. Conclusions Early treatment of HBO at two different pressures is of good effect on the recovery of patients with cerebral trau-ma suffering from post-operative coma,and HBO treatment at the pressure of 0.25MPa may be of more superior effect.