高压氧联合醒脑静注射液对创伤性脑损伤昏迷患者意识改善及血清SOD、NO的影响

Effects of hyperbaric oxygen combined with Xingnaojing injection on the consciousness improvement and serum SOD and NO in comatose patients with traumatic brain injury

目的 探讨临床治疗创伤性脑损伤(TBI)昏迷患者,单用醒脑静注射液与高压氧联合醒脑静注射液的2种治疗方式对于患者意识改善及血清中氧化应激指标水平的影响。方法 采用回顾性调查研究法,整理2021年5月1日-2022年1月31日在合肥市第二人民医院高压氧科及神经外科治疗的56例重度TBI昏迷患者的临床资料,根据在院期间患者是否接受高压氧治疗分为高压氧治疗组(观察组)32例和未接受高压氧治疗组(对照组)24例。利用格拉斯哥昏迷量表(GCS)对2组患者治疗前后意识状态进行评估并记录,检测2组治疗前、治疗第10天、治疗第20天血清超氧化物歧化酶(SOD)、一氧化氮(NO)水平并记录患者苏醒率。结果 治疗后,2组患者GCS评分均较治疗前增高(均P<0.05),观察组GCS评分为(9.22±2.27)分,明显高于对照组[(7.71±2.77)分,P<0.05];且观察组苏醒率[59.4%(19/32)]明显高于对照组[29.2%(7/24),P<0.05]。2组治疗前、治疗第10天和第20天的SOD值均依次上升。2组治疗前、治疗第10天和第20天的NO值均依次下降。结论 高压氧联合醒脑静注射液治疗创伤性脑损伤昏迷患者可更明显地改善患者意识状态,提升苏醒率,其可能的作用机制与血清SOD水平升高及血清NO水平下降有关。

Objective This study aims to investigate the effects of two therapeutic methods of Xingnaojing injection alone and hyperbaric oxygen combined with Xingnaojing injection on the improvement of consciousness and the levels of SOD and NO in serum of patients with coma caused by traumatic brain injury(TBI). Methods The clinical data of 56 patients with severe TBI coma who were treated in the hyperbaric oxygen department and neurosurgery department of Hefei Second People’s Hospital from May 1, 2021 to January 31, 2022 were collected by retrospective investigation. The patients were divided into the hyperbaric oxygen treatment group(observation group) and non-hyperbaric oxygen treatment group(control group) based on whether they received hyperbaric oxygen treatment during the hospital period, including 32 patients in the observation group and 24 patients in the control group. The Glasgow coma scale(GCS) was used to assess and record the consciousness status in the two groups of patients before and after treatment. The levels of serum superoxide dismutase(SOD) and nitric oxide(NO) were measured before treatment, on the 10th and 20th days of treatment in 2 groups, meantime, the recovery rate of patients was recorded. Results The GCS score of the two groups after treatment was higher than that before treatment(all P<0.05). The GCS score of the observation group after treatment increased to(9.22±2.27) points, which was significantly higher than that of the control group after treatment [(7.71±2.77) points, P<0.05]. The recovery rate of the observation group [59.4%(19/32)] was significantly higher than that of the control group [29.2%(7/24), P<0.05]. The SOD level of the two groups increased sequentially before treatment, on the 10th and 20th days of treatment. While, the NO level of the two groups decreased sequentially before treatment, on the 10th and 20th days of treatment. Conclusion Hyperbaric oxygen combined with Xingnaojing injection can significantly improve the consciousness of patients with coma caused by traumatic brain injury, and increase the recovery rate. Furthermore, its possible mechanism is related to the increase of serum SOD level and the decrease of serum NO level.