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目的探讨高压氧联合改良去大骨瓣减压术对重型颅脑损伤(STBI)患者术后血清神经元特异性烯醇化酶(NSE)、前清蛋白(PA)水平及生活质量的影响。方法选取2014年6月—2017年3月延安大学咸阳医院收治的STBI患者100例,根据手术方式分为对照组和研究组,每组50例。在常规对症治疗基础上,对照组患者行常规去大骨瓣减压术,研究组患者行高压氧联合改良去大骨瓣减压术。比较两组患者手术前后血清NSE、PA、丙二醛(MDA)和超氧化物歧化酶(SOD-1)水平,术前及术后3个月生活质量。结果术前两组患者血清NSE、PA、MDA、SOD-1水平比较,差异无统计学意义(P>0.05);术后研究组患者血清NSE、MDA水平低于对照组,血清PA、SOD-1水平高于对照组(P<0.05)。术前两组患者精神状态评分、健康状况评分、社会功能评分、躯体疼痛评分比较,差异无统计学意义(P>0.05);术后3个月研究组患者精神状态评分、健康状况评分、社会功能评分、躯体疼痛评分高于对照组(P<0.05)。结论高压氧联合改良去大骨瓣减压术可有效降低STBI患者血清NSE水平,提高血清PA水平及患者生活质量,有利于减轻氧化应激反应。
Objective To investigate the effects of hyperbaric oxygen combined with modified decompressive craniectomy on postoperative serum neuron specific enolase (NSE), prealbumin (PA) and quality of life in patients with severe craniocerebral injury (STBI). Methods From January 2014 to March 2017, 100 patients with STBI who were treated in Xianyang Hospital of Yan’an University were enrolled in this study. The patients were divided into control group and study group according to the operation mode, 50 cases in each group. On the basis of conventional symptomatic treatment, patients in the control group underwent conventional decompressive craniectomy. Patients in the study group underwent hyperbaric oxygenation combined with decompressive craniectomy. The serum levels of NSE, PA, MDA and SOD-1 in the two groups were compared before and after operation, and the quality of life before and 3 months after operation. Results There was no significant difference in serum NSE, PA, MDA and SOD-1 levels between the two groups before operation (P> 0.05). Serum levels of NSE and MDA in postoperative study group were lower than those in control group, 1 level higher than the control group (P <0.05). There were no significant differences in mental status score, health status score, social function score and somatic pain score between the two groups before operation (P> 0.05); in the three months postoperatively, scores of mental status, health score, social status Function score and somatic pain score were higher than those in control group (P <0.05). Conclusions Hyperbaric oxygen combined with decompressive craniectomy can effectively reduce the level of serum NSE, improve serum PA level and quality of life in patients with STBI, which is beneficial to reduce oxidative stress.