早期应用高压氧联合调神疏肝针电刺激法治疗颅脑损伤后认知功能障碍疗效观察和安全性评价

Clinical Efficacy and Safety of Cognition Functional Disorder after Traumatic Brain Injury Receiving Early Hyperbaric Oxygen Therapy Combined with Electrical Stimulation Method of Regulating Mind and Relieving the Depressed Liver Needling

目的:探讨早期应用高压氧(Hyperbaric oxygen,HBO)联合调神疏肝针电刺激法治疗颅脑损伤(Traumatic Brain Injury,TBI)后认知功能障碍的疗效,并进行安全性评估。方法:将2008年10月—2015年10月在我院神经外科住院治疗的105例TBI后合并认知功能障碍患者随机分为3组,对照组给予常规治疗,治疗1组给予常规+HBO治疗,治疗2组给予常规+HBO+调神疏肝针电刺激法治疗。采用简易智能精神状态表(Mini Mental State Examination,MMSE)、功能综合评定量表(Functional Comprehensive Assessment,FCA),观察3组治疗前后MMSE、FCA评分和MMSE、FCA评分提高值以及平均住院时间,并进行组间比较。结果:对照组治疗后MMSE评分(21.63±3.62)分显著低于治疗1组(23.57±3.56)分和治疗2组(25.46±2.90)分,组间比较差异均有统计学意义(P<0.01);对照组治疗后FCA评分(54.77±5.54)分显著低于治疗1组(62.31±8.91)分和治疗2组(74.29±8.61)分,组间比较差异均有统计学意义(P<0.01);对照组MMSE评分提高值(1.43±0.81)分别低于治疗1组(3.46±1.50)分和治疗2组(4.86±2.12)分,组间比较差异均有统计学意义(P<0.01);对照组FCA评分提高值(7.60±1.93)分别低于治疗1组(9.80±2.39)分和治疗2组(11.69±2.25)分,组间比较差异均有统计学意义(P<0.01);对照组平均住院时间(34.31±4.79)d显著低于治疗1组(30.29±4.22)d和治疗2组(27.60±3.75)d,组间比较差异均有统计学意义(P<0.01)。结论:HBO联合调神疏肝针电刺激法治疗TBI后认知功能障碍能明显缩短病程、提高疗效且安全性较高,临床上值得推荐。

Objective：To research the clinical efficacy and safety of cognition functional disorder receiving early hyperbaric oxygen therapy combined with electrical stimulation method of regulating mind and relieving the depressed liver needling after traumatic brain injury. Methods：105 patients with cognition functional disorder after traumatic brain injury were collected in the department of neurosurgery of Shanghai Fengxian center hospital from October 2008 to October 2015 and were randomly divided into three groups. Patients in the control group were given neurosurgery routine therapy. Patients in the treatment group 1 were given neurosurgery routine therapy combined with hyperbaric oxygen therapy. Patients in the treatment group 2 were given electrical stimulation method of regulating mind and relieving the depressed liver needling on the basis therapy of patients in the treatment group 1. The MMSE and FCA scores、improve value of MMSE and FCA scores,average stay in hospital and curative effect were compared among three groups. Results：The MMSE scores（21.63±3.62）in the control group was significantly lower than the treatment group 1（23.57±3.56）and the treatment group 2（25.46±2.90）after treatment. The difference among three groups was statistically significant（P〈0.01）. The FCA scores（54.77±5.54）in the control group was significantly lower than the treatment group 1（62.31±8.91）and the treatment group 2（74.29±8.61）after treatment. The difference among three groups was statistically significant（P〈0.01）. The improve value of MMSE scores（1.43±0.81）in the control group was significantly lower than the treatment group 1（3.46±1.50）and the treatment group 2（4.86±2.12）after treatment. The difference among three groups was statistically significant（P〈0.01）. The improve value of FCA scores（7.60±1.93）in the control groupwas significantly lower than the treatment group 1（9.80±2.39）and the treatment group 2（11.69±2.25）after treatment. The difference among three groups was statistically significant（P〈0.01）. The average stay in hospita（l34.31±4.79） d in the control group was significantly lower than the treatment group 1（30.29±4.22）d and the treatment group 2（27.60±3.75）d after treatment. The difference among three groups was statistically significant（P〈0.01）. Conclusion：Cognition functional disorder after traumatic brain injury receiving early hyperbaric oxygen therapy and electrical stimulation method of regulating mind and relieving the depressed liver needling can obviously shorten the course of disease and improve the therapeutic effect.The comprehensive treatment have superior safety. Therefore,there should be recommended in clinical practice.