高压氧联合黄体酮治疗中重度创伤性脑损伤后血性激素的变化及预后分析

Changes of hemoglobin in the treatment of moderate and severe traumatic brain injury by hyperbaric oxygenation combined with progesterone and prognostic relevance

目的研究高压氧联合黄体酮治疗中重度创伤性脑损伤对血性激素以及预后的影响。方法将2016年1月到2016年6月间的90例中重度创伤性脑损伤(TBI)患者随机分成3组,分别采用高压氧、黄体酮、高压氧联合黄体酮治疗,比较各组患者的血清中孕酮、雌二醇及睾酮的变化,格拉斯哥昏迷(GCS)评分以及格拉斯哥预后(GOS)评分。结果治疗结束后,高压氧联合黄体酮组的孕酮、雌二醇明显高于黄体酮组与高压氧组,而睾酮水平明显低于黄体酮组与高压氧组,组间差异具有统计学意义(P<0.05);治疗结束后,高压氧联合黄体酮组的GCS评分明显高于黄体酮组和高压氧组,组间差异具有统计学意义(P<0.05);随访6个月,高压氧联合黄体酮组的GOS评分明显高于黄体酮组和高压氧组,组间差异具有统计学意义(P<0.05)。结论高压氧联合黄体酮治疗中重度TBI,有效的提高了患者孕酮、雌二醇水平,降低了睾酮水平,改善了预后。

Objective To study the effects of hyperbaric oxygenation combined with progesterone on hemoglobin and prognosis in moderate and severe traumatic brain injury. Methods Ninety patients with mo^terate and severe traumatic brain in- jury （TBI） from January 2016 to June 2016 were randomly divided into three groups. Hyperbaric oxygenation, progesterone, and hyperbaric oxygenation combined with progesterone treatment were used respectively in three groups. We compared changes of progesterone, estradiol and testosterone in the serum, Glasgow coma （GCS） score, and Glasgow prognosis （GOS） score among groups. Results After the treatment, the levels of progesterone and estradiol in hyperbaric oxygenation combined with progester- one group were significantly higher than those in progesterone group and hyperbaric oxygenation group, while testosterone level was Significantly lower than that in progesterone group and hyperbaric oxygenation group, with significant difference （P〈0.05）. After the treatment, the GCS score in hyperbaric oxygenation combined with progesterone group was significantly higher than that in progesterone group and hyperbaric oxygenation group, and the difference was significant （P〈0.05）. In the six-m0nth follow- up, the GOS score in hyperbaric oxygenation combined with progesterone group was significantly higher than that in progesterone group and hyperbaric oxygenation group, with significant difference （P〈0.05）. Conclusion Hyperbaric oxygenation combined with progesterone can effectively improve the levels of progesterone and estradiol, decrease the testosterone level, and improve prognosis for the treatment of moderate and severe TBI.