臭氧自血疗法对重型颅脑损伤昏迷患者的促醒作用

Effects of Ozone Autohemotherapy on Awakening Patients from Coma in Severe Traumatic Brain Injury

目的观察臭氧自血疗法对重型颅脑损伤昏迷患者的促醒作用。方法收集郑州大学第五附属医院神经外科病区自2018年1月1日至2020年1月1日收治的重型颅脑损伤昏迷患者共51例,其中28例接受常规治疗(对照组),23例在常规治疗基础上接受臭氧治疗(研究组)。采用格拉斯哥昏迷评分(GCS)评估治疗2个疗程后患者昏迷程度,采用意识水平(LOC)评分评估3个月后两组有效率,分别比较两组患者血液流变学(高切黏度、低切黏度、血浆黏度及红细胞比容)变化及胶质纤维酸性蛋白(GFAP)水平。结果臭氧治疗2个疗程后,研究组的GCS评分高于对照组(P<0.05),研究组全血高切黏度、低切黏度、血浆黏度及红细胞比容均低于对照组(P<0.05),研究组血清GFAP水平低于对照组(P<0.05);研究组和对照组各自组内治疗前后比较,上述指标差异有统计学意义(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05);治疗3个月后,研究组有效率高于对照组(P<0.05)。结论臭氧自血疗法可有效改善重型颅脑损伤昏迷患者的GCS评分,降低血液黏度,增加血液流速,改善组织供氧,清除自由基,对促醒有益。

Objective To observe the effects of ozone autohemotherapy on comatose patients with severe traumatic brain injury(sTBI).Methods A total of 51 patients with sTBI in coma in the Department of Neurosurgery of the Fifth Affiliated Hospital of Zhengzhou University from January 1st,2018 to January 1st,2020 were included in the study.Among them,28 cases received conventional treatment(control group),and 23 patients received ozone autohemotherapy on the basis of conventional treatment(study group).Glasgow coma scale(GCS)was used to evaluate the degree of coma after 2 courses of treatment,and level of consciousness(LOC)score was used to evaluate the effectiveness of the two groups after 3 months.The changes of hemorheology(high shear viscosity,low shear viscosity,plasma viscosity and hematocrit value)and the level of glial fibrillary acidic protein(GFAP)were compared between the two groups.Results After 2 courses of ozone autohemotherapy,GCS score in study group was higher than that in control group(P<0.05).The high shear viscosity,low shear viscosity,plasma viscosity and hematocrit value of whole blood in study group were lower than those in control group(P<0.05).The level of GFAP in the serum of study group was lower than that of control group(P<0.05).The above indicators of study group and control group had statistical differences before and after the treatment(P<0.05).There was no statistical difference between the two groups in the incidence of adverse reactions(P>0.05).After 3 months of treatment,the effective rate of study group was higher than that of control group(P<0.05).Conclusion Ozone autohemotherapy could effectively improve GCS score,reduce blood viscosity,increase blood flow rate,improve tissue oxygen supply,and scavenge free radicals,which is beneficial to promote awakening.