高压氧治疗弥漫性轴索损伤的临床疗效分析

The clinical effect of hyperbaric oxygen therapy on the patients with diffuse axonal injury

目的探讨高压氧治疗弥漫性轴索损伤(DAI)的临床疗效以及开始治疗时机对疗效的影响。方法 84例DAI患者根据是否接受高压氧治疗分为治疗组和对照组各42例,采用格拉斯哥预后评分(GOS)及简明精神状态检查量表(MMSE)和日常活动能力量表(ADL)进行临床疗效及预后比较分析。治疗组患者42例根据伤后高压氧治疗开始时间分为A、B两组,比较治疗效果。结果按GOS评分评定预后,治疗组预后良好20例(47.62%),对照组预后良好8例(19.05%),两组预后良好率差异有统计学意义(P<0.05)。治疗组治疗前后MMSE、ADL评分两者差异有统计学意义(P<0.05)。对照组治疗前后MMSE、ADL评分差异有统计学意义(P<0.05)。治疗组的MMSE、ADL评分均较对照组有统计学差异(P<0.05)。治疗组的42例患者中,A组与B组的MMSE、ADL评分比较差异有统计学意义(P<0.05)。结论高压氧辅助治疗弥漫性轴索损伤可以明显降低病死率,同时强调早期治疗可改善患者的预后。

Objective To observe the clinical effect of hyperbaric oxygen therapy（HBOT） and impact of the different start time of HBOT on the patients with diffuse axonal injury（DAD. Methods 84 patients with cognitive dysfunction DAI were divided into HBOT treatment group （42 cases） and conventional treatment group （42 cases）. The clinical effect and prognosis was determined by Glasgow outcome score （GOS） and mini-mental state examination （MMSE） and activities of daily life （ADL） before and 6 months after the treatment in all the patients. 42 patients of HBOT treatment group were divided into group A （20 cases） and group B （22cases）, according to the start time of HBOT. The clinical effect was observed and compared between the two groups. Results The rate of good prognosis in HBOT group （47.62%, 20/ 42） was significantly higher than that in the conventional treatment group （19.05 %, 8/42） 6 months after the treatment （P〈0.05）. There were significantly differences in MMSE and ADL scores before and 6 months after HBOT in HBOT group （P〈0.05）. There were significantly differences in MMSE and ADL scores before and 6 months after the treat- ment in the conventional treatment group. There were significantly differences in MMSE and ADL scores 6 months after the treatment between both the HBOT and conventional treatment groups （P^0.05）. The MMSE and ADL scores in the A group were better than those of B group there were significant differences between the two groups （P~ 0.05）. Conclusion HBOT has important effect on treatment of diffuse axonaI injury. It can obviously decrease mortality rate and improve prognosis. The earlier the treatment starts, the better the curative effect is when the hyperbaric oxygen therapy is applied to the patients with DAI.