高压氧联合标准外伤大骨瓣减压手术治疗重型颅脑外伤的预后分析

Clinical analysis of hyperbaric oxygen combined with standard large trauma craniotomy in the treatment of severe traumatic brain injury

目的:分析高压氧联合标准外伤大骨瓣减压手术治疗重型颅脑外损伤的预后情况。方法:选取2012年1月至2015年12月广西北流市人民医院收治的重型颅脑损伤患者88例,按随机数字表法分为观察组和对照组,每组44例。对照组行常规标准外伤大骨瓣减压手术,观察组在对照组基础上联合高压氧治疗。观察两组患者治疗45d后的死亡例数、清醒例数及清醒患者意识恢复时间。比较两组患者高压氧治疗前、后格拉斯哥昏迷评分(GCS评分)以及随访6个月后,两组患者的预后情况。结果:治疗45d后,观察组患者病死率明显低于对照组,清醒率明显高于对照组,意识恢复时间观察组明显短于对照组,且差异均具有统计学意义(均P<0.05)。两组患者治疗前GCS评分比较,差异无统计学意义(P>0.05),治疗后两组患者GCS评分均明显提高,但观察组GCS评分明显高于对照组,差异具有统计学意义(P<0.05)。随访6个月后,观察组患者预后情况明显优于对照组,格拉斯哥预后评分量表(GOS)评分明显高于对照组,差异均具有统计学意义(均P<0.05)。结论:高压氧联合标准外伤大骨瓣减压手术对于重型颅脑外伤具有较好的治疗作用,能够有效降低患者病死率,并改善患者预后。

Objective： To investigate the effect of hyperbaric oxygen combined with standard large trauma craniotomy on the prognosis of severe traumatic brain injury. Methods： 88 patients with severe traumatic brain injury in our hospital from January 2012 to December 2015 were selected and randomly divided into an observation group and a control group, with 44 cases in each group. The patients in the control group received standard large trauma craniotomy, while those in the observation group were treated as the control group with the addition of hyperbaric oxygen therapy. The clinical outcomes were compared between the two groups. Results：After 45 days of treatment, the mortality rate was lower, while the consciousness re- covery rate and the Glasgow coma scale （GCS） score were higher in the observation group than those in the control group （ P d0.05）. The recovery time of the observation group was significantly shorter than that of the control group （ P 〈0.05）. After 6 months of treatment, the Glasgow outcome scale （GOS） score in the observation group was higher than that in the control group （ P 〈0.05）. Conclusion： Hyperbaric oxygen combined with standard large trauma craniotomy had a curative effect on severe trauma brain injury. This combination could effectively reduce the mortality rate and improve the prognosis of patients.