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目的探讨早期高压氧治疗对重型颅脑创伤患者预后和神经功能的影响。方法选取2014年7月—2015年9月浦东新区人民医院收治的重型颅脑创伤患者66例,根据高压氧治疗时机分为对照组34例和观察组32例。两组患者入院后均行急诊开颅去骨瓣减压术及常规支持治疗,对照组患者于术后1~3周开始行高压氧治疗,观察组患者于术后5~20 h开始行高压氧治疗;两组患者均连续治疗2周。比较两组患者治疗后6个月预后,入院时及治疗2周后格拉斯哥昏迷量表(GCS)评分和美国国立卫生研究院卒中量表(NIHSS)评分。结果观察组患者预后优于对照组(P<0.05)。治疗前两组患者GCS评分、NIHSS评分比较,差异无统计学意义(P>0.05);治疗后观察组患者GCS评分高于对照组,NIHSS评分低于对照组(P<0.05);治疗后两组患者GCS评分均高于治疗前,NIHSS评分均低于治疗前(P<0.05)。结论早期高压氧治疗可有效促进重型脑创伤患者神经功能的恢复,改善患者认知功能及预后。
Objective To investigate the effect of early hyperbaric oxygen therapy on prognosis and neurological function in patients with severe traumatic brain injury. Methods 66 patients with severe craniocerebral trauma who were admitted to Pudong New Area People’s Hospital from July 2014 to September 2015 were divided into control group (n = 34) and observation group (n = 32) according to the timing of hyperbaric oxygen therapy. Patients in both groups underwent emergency craniotomy decompression and conventional supportive therapy after admission. Patients in the control group started hyperbaric oxygen therapy 1 to 3 weeks after operation, and patients in the observation group started high pressure Oxygen therapy; two groups of patients were treated for 2 weeks. The prognosis at 6 months after treatment, Glasgow coma scale (GCS) score and NIH Stroke Scale (NIHSS) score at admission and after 2 weeks of treatment were compared between the two groups. Results The prognosis of observation group was better than that of control group (P <0.05). The scores of GCS and NIHSS in the two groups before treatment were no significant difference (P> 0.05). After treatment, the score of GCS in the observation group was higher than that in the control group, and the NIHSS score was lower than that in the control group (P <0.05) The GCS scores of the patients in the two groups were higher than those before treatment, and the NIHSS scores were lower than before treatment (P <0.05). Conclusions Early hyperbaric oxygen therapy can effectively promote the recovery of neurological function and improve cognitive function and prognosis in patients with severe traumatic brain injury.