不同疗程高压氧治疗重型颅脑损伤的预后分析

Analysis of the outcomes on severe traumatic brain-injured treated by different courses hyperbaric oxygen therapy

目的探讨不同疗程高压氧对重型颅脑损伤患者预后的影响。方法选取收治的重型颅脑损伤患者60例,分为5~7 d疗程组(A组)20例,10~14 d疗程组(B组)20例,15~20 d疗程组(C组)20例。在术后常规治疗基础上,分别行高压氧治疗,比较高压氧治疗前、治疗后GCS评分改变及6个月后GOS评级,观察高压氧治疗不同疗程的显效率。结果 3组患者治疗后第1天GCS评分较治疗前均明显升高(P<0.05)。治疗后第1天B组和C组患者GCS评分明显高于A组(P<0.05),B组GCS评分明显高于C组(P<0.05)。3组患者经治疗后第6周GCS评分较治疗前均明显升高(P<0.05),治疗后第6周B组和C组患者GCS评分明显高于A组(P<0.05),B组GCS评分高于C组(P<0.05)。B组、C组患者6个月后GOS评级良好率高于A组,B组预后GOS良好率高于C组患者,差异均有统计学意义(P<0.05)。结论高压氧辅助治疗可以提高重型颅脑损伤患者的治愈率和预后疗效,且10~14 d的疗程相对最佳。

Objective To investigate the effect of different courses hyperbaric oxygen therapy on the patients with severe traumatic brain injury. Methods Sixty patients with severe craniocerebral injury admitted in the First People＇s Hospital of Yinchuan from Jan. 2013 to Dec. 2016 were randomly divided into three groups, group A： 5 -7 days treatment group （n =20） ;group B：10 - 14 days treatment group （n = 20） ;and group C：15 -20 days treatment group （n = 20）. On the basis of conventional treatment, hyperbaric oxygen therapy was performed to compare the GCS score before and after hyperbaric oxygen therapy and GOS rate after 6 months, observed the efficiency of hyperbaric oxygen therapy with different courses. Results GCS scores of the three groups were significantly higher than those before treatment （ P 〈 0.05 ）. The GCS score of group B and group C was significantly higher than that in group A （ P 〈 0.05 ）.The GCS score of group B was also significantly higher than that in group C （ P 〈 O. 05 ）. The GCS scores of the three groups were significantly higher than those before treatment （P 〈 0.05）. The GCS score of group B and group C was significantly higher than that of group A （ P 〈 0. 05 ） at 6 weeks after treatment, and GCS score in group B was higher than that in group C （ P 〈 0. 05 ）. The better rate of GOS in group B and C was higher than that in group A at 6 months. The difference of GOS in group B was higher than that in group C （ P 〈 0. 05 ）. Conclusion Hyperbaric oxygen therapy can effectively improve the cure rate and prognosis of patients with severe traumatic brain injury, and 10 to 14 days of treatment is relatively best.