神经节苷脂与高压氧联合治疗重型颅脑损伤患者的临床疗效

Clinical efficacy of ganglioside combined with hyperbaric oxygen in the treatment of patients with severe craniocerebral injury

目的:探讨神经节苷脂与高压氧联合治疗重型颅脑损伤患者的临床疗效。方法:对我院2013年10月至2016年10月期间收治的110例重型颅脑损伤患者的临床资料进行回顾性分析,将入组的患者根据随机原则分为对照组和研究组,每组55例。对照组患者采用100mg·d^(-1)神经节苷脂治疗,持续治疗2w后,改为40mg·d^(-1),持续治疗1m。研究组患者在对照组的基础上联合高压氧治疗,加压20min后持续吸氧60min,减压25min,中间休息2次共15min,1次·d^(-1),持续治疗1m。比较两组患者的临床疗效、治疗前后格拉斯哥昏迷(Glasgow coma scale,GCS)评分及巴氏指数(Barthel)评分。结果:研究组患者的治愈率、重残及死亡率分别为36.36%、7.27%、3.64%,显著优于对照组的16.36%、23.64%、18.18%(P<0.05);治疗后研究组患者的Barthel指数及GCS评分分别为69.13±7.56分以及11.64±2.78分,显著优于对照组的51.27±8.64分与11.64±2.78分(P<0.05)。结论:神经节苷脂与高压氧联合应用能有效的改善重型颅脑损伤患者的神经功能,疗效安全可靠,具有重要的临床应用价值。

Objective：To investigate the clinical efficacy of ganglioside combined with hyperbaric oxygen in the treatment of patients with severe craniocerebral injury.Methods：The clinical data of 110 patients with severe craniocerebral injury admitted to our hospital from October 2013 to October 2016 were retrospectively analyzed.The patients were randomly divided into control group and study group,55 cases in each group.Patients in the control group were treated with ganglioside,100 mg·d^（-1） after continuous treatment of 2 w,changed to 40 mg·d^（-1）,continuous treatment of 1 m.Patients in the study group were treated with hyperbaric oxygen therapy on the basis of the control group,after 20 min of pressure,the oxygen was continued for a maximum of 60 min,the pressure was reduced by 25 min,a break of 2 times total 15 min,1 times·d^（-1）,continuous treatment of 1 m.The clinical efficacy of two groups of patients,GCS score and Barthel score before and after treatment were compared.Results：The cure rate,severe disability and mortality of the study group were 36.36%,7.27%,and 3.64%,respectively,which were higher than the control group（16.36%,23.64%,18.18%,P〈0.05）.After treatment,the Barthel and GCS score of the study group were 69.13±7.56 and 11.64±2.78,significantly better than the control group（51.27±8.64 and 11.64±2.78,P〈0.05）.Conclusion：Combination of ganglioside and hyperbaric oxygen can effectively improve the neurological function of patients with severe craniocerebral injury,with safe and reliable curative effect,and has important clinical value.