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目的探讨重度脑外伤患者早期高压氧治疗的临床效果。方法重度脑挫裂伤患者56例,入院时患者的格拉氏哥评分(glasgowcomascale,GCS)为3~8分,均于入院1h内行去骨瓣减压术或同时行血肿清除术;20例在伤后5~20h内行早期高压氧(HBO)治疗,36例在脑水肿消退后(7~18d)行常规HBO治疗。两组均治疗2个疗程。观察3周后重新GCS评分,6个月后进行格拉氏哥结果评级(glasgowoutcomescale,GOS)。结果两组患者治疗后3周GCS评分和6个月后GOS评分差异具有统计学意义。早期HBO治疗组明显优于常规HBO治疗组。结论早期的HBO治疗可以及时提高血氧含量,阻止恶性缺血缺氧的发生。重度脑挫裂伤患者术后在可能的条件下应尽早行HBO治疗,以提高患者的生存质量。
Objective To investigate the clinical effects of early hyperbaric oxygen therapy in patients with severe traumatic brain injury. Methods Fifty-six patients with severe contusion and laceration were enrolled in this study. The patients had a GCS score of 3 to 8 at admission. All patients underwent decompressive craniofacial decompression or simultaneous hematoma removal within 1 hour after admission. Twenty During the first 5 to 20 hours after injury, HBO was given in the early stage and 36 cases were treated with conventional HBO after cerebral edema subsided (7 ~ 18 days). Two groups were treated 2 courses. The GCS score was observed after 3 weeks and glasgow outcome scale (GOS) 6 months later. Results The difference of GOS score between the two groups after 3 weeks of treatment and the GOS score after 6 months was statistically significant. Early HBO treatment group was significantly better than conventional HBO treatment group. Conclusion Early HBO treatment can improve blood oxygen content in time and prevent the occurrence of malignant ischemia and hypoxia. Severe cerebral contusion patients should be treated with HBO as soon as possible after surgery to improve the quality of life of patients.