重型颅脑损伤患者采用高压氧联合标准脑外伤大骨瓣开颅减压术的疗效观察

Clinical effect of hyperbaric oxygen combined with standard large trauma craniotomy on severe traumatic brain injury

目的探讨对重型颅脑损伤患者采用高压氧联合标准脑外伤大骨瓣开颅减压手术的临床疗效。方法选取我院因重度颅脑损伤(GCS≤8分)行手术治疗的患者120例,按照随机分配的原则分为对照组和观察组。其中60例采用标准脑外伤大骨瓣减压手术配合常规治疗的患者作为对照组,另外60例在对照组基础上联合高压氧治疗的患者作为观察组,比较两组患者的临床疗效。结果两组患者治疗前的GCS评分无明显差异(P>0.05);两组患者治疗后的GCS评分均较治疗前升高,且观察组的GCS评分高于对照组(P<0.05)。随访结果显示,观察组患者的GOS评分明显高于对照组,同时预后良好率明显优于对照组患者(P<0.05)。结论标准脑外伤大骨瓣开颅手术的同时联合高压氧治疗,对于降低重型颅脑损伤的重残率、死亡率,提高患者的生存质量具有积极的意义,可在临床治疗中推广使用。

Objective To explore the effecls of hyperbaric oxygen combined with standard large trauma craniolomy on severe lraumalic brain injury. Methods A lolal of 120 palienls wilh severe lraumalic brain injury （ GCS≤8） in our hospilal were selected and randomly divided into observation group and control group. The 60 cases received normal treatment and standard large trauma craniolomy were selected as lhe control group; on this basis, 60 cases added hyperbaric oxygen were selected as lhe observation group. The clinical efficacy of lhe lwo groups were compared. Results There was no significant difference in lhe GCS scores between lhe lwo groups before treatment （ P〉0.05）; after treatment, lhe GCS scores of lhe lwo groups were higher than those before treatment, and lhe GCS score of lhe observation group was higher than lhal of lhe control group （ P〈0.05）. Follow-up results showed lhal lhe GOS score of lhe observation group was significantly higher than lhal of lhe control group, and lhe favorable prognosis rale in lhe observation group was significantly belter than lhal in lhe control group （ P 〈0.05）. Conclusion Hyperbaric oxygen combined wilh standard large trauma craniolomy has positive significance on reducing severe disability, mortality, improving lhe palienls＇ quality of life in palienls wilh severe lraumalic brain injury, which can be used in clinical treatment.