高压氧联合标准外伤大骨瓣减压手术治疗重型颅脑外伤临床观察

Clinical observation of hyperbaric oxygen combined with standard traumatic large bone flap decompression surgery for severe head injury

目的研究重型颅脑外伤患者接受高压氧联合标准外伤大骨瓣减压手术治疗的临床效果。方法纳入菏泽市立医院收治的重型颅脑外伤患者76例为研究对象,采用随机数字表法分为2组,对照组38例,行单一标准外伤大骨瓣减压术治疗;实验组38例,于对照组治疗基础上,加以高压氧行综合治疗。比较2组综合疗效。结果2组治疗前血尿指标、NIHSS评分、GCS评分比较,差异无统计学意义(P>0.05);治疗后,2组血尿指标中尿L-FABP、GFAP、MBP、NSE表达水平及NIHSS评分均低于治疗前,TFPI-1、TFPI-1抗原表达水平及GCS评分均高于治疗前,差异有统计学意义(P<0.05);实验组治疗后尿L-FABP、GFAP、MBP、NSE表达水平及NIHSS评分均低于对照组,TFPI-1、TFPI-1抗原表达水平及GCS评分均高于对照组,差异有统计学意义(P<0.05)。实验组意识恢复时间短于对照组,预后优于对照组,差异有统计学意义(P<0.05)。结论重型颅脑外伤患者予以标准外伤大骨瓣减压术联合高压氧治疗,有助于改善患者血尿指标水平,修复神经功能缺损,促进意识及早恢复,纠正意识障碍,有利于患者预后。

Objective To study the clinical effect of hyperbaric oxygen combined with standard trauma decompression surgery for patients with severe craniocerebral trauma.Methods 76 patients with severe craniocerebral trauma admitted in Heze City Hospital were included in the study.They were divided into 2 groups by random number table method,38 cases in the control group and treated with single standard traumatic large bone flap decompression;38 cases in the experimental group,Based on the treatment of the control group,hyperbaric oxygen was used for comprehensive treatment.The comprehensive efficacy of the two groups was compared.Results There was no significant difference in hematuria index,NIHSS score and GCS score before treatment between the two groups(P>0.05);after treatment,the expression levels of urinary L FABP,GFAP,MBP,NSE and NIHSS score in the hematuria indexes of the two groups were all Lower than before treatment,TFPI 1,TFPI 1 antigen expression level and GCS score were higher than before treatment,the difference was statistically significant(P<0.05);urine L FABP,GFAP,MBP,NSE expression in the experimental group after treatment.The level and NIHSS score were lower than the control group,TFPI 1,TFPI 1 antigen expression level and GCS score were higher than the control group,the difference was statistically significant(P<0.05).The recovery time of consciousness in the experimental group was shorter than that in the control group,and the prognosis was better than that in the control group,the difference was statistically significant(P<0.05).Conclusion Patients with severe craniocerebral trauma receiving standard traumatic large bone flap decompression combined with hyperbaric oxygen therapy can help improve the patient's hematuria index level,repair neurological deficits,promote early recovery of consciousness,correct consciousness disorders,and benefit the prognosis of patients.