摘要
目的探讨早期不同频次高压氧联合亚低温对重度颅脑外伤(sTBI)患者脑神经功能的影响。方法选取泰兴市人民医院2016年3月至2019年2月收治的86例sTBI患者为研究对象,分成A组和B组,每组43例。两组给予不同频次高压氧联合亚低温治疗,其中A组高压氧治疗每天2次,B组高压氧治疗每天1次。格拉斯哥预后(GOS)评分评估两组治疗后6个月的预后情况;治疗前、治疗后6个月采血,检测神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)、神经胶质纤维酸性蛋白(GFAP)、S100B蛋白(S-100B)、天冬氨酸(Asp)、γ-氨基丁酸(GABA)、谷氨酸(Glu)水平;观察两组并发症发生率。结果A组中度残疾率明显高于B组,重度残疾率明显低于B组(P<0.05)。两组治疗后血清NSE、MBP、GFAP、S-100B水平均明显低于治疗前,且A组明显低于B组(P<0.05)。两组治疗后血清Asp水平明显低于治疗前,GABA水平明显高于治疗前,且A组变化更明显(P<0.05)。两组肺不张、室性心律失常、坠积性肺炎、静脉血栓发生率比较差异无统计学意义(P>0.05)。结论早期采用每天2次高压氧联合亚低温治疗sTBI患者,对脑神经功能保护作用更明显,可进一步改善预后。
Objective To explore the effect of early different frequencies of hyperbaric oxygen combined with subhypothermia on the brain nerve function in the patients with severe craniocerebral trauma(sTBI).Methods Eighty-six cases of sTBI admitted to the Taixing Municipal People′s Hospital from March 2016 to February 2019 were selected as the study subjects and divided into the group A and B,43 cases in each group.The two groups were given different frequencies of hyperbaric oxygen combined with subhypothermia therapy,in which the group A was treated by the hyperbaric oxygen treatment twice daily,and the group B was treated by the hyperbaric oxygen treatment once daily.The prognosis after 6-month treatment in the two groups was evaluated by using the Glasgow Prognostic Score(GOS).The blood samples were collected before treatment and in 6 months after treatment.The levels of neuron-specific enolase(NSE),myelin basic protein(MBP),glial fibrillary acidic protein(GFAP),S100B protein(S-100B),aspartic acid(ASP),gamma aminobutyric acid(GABA)and glutamic acid(Glu)were detected.The incidence rate of complications was observed in the two groups.Results The moderate disability rate in the group A was significantly higher than that in the group B,and the severe disability rate was significantly lower than that in the group B(P<0.05).The levels of serum NSE,MBP,GFAP and S-100B after treatment in the two groups were significantly lower than those before treatment,moreover,the levels in the group A were significantly lower than those in the group B(P<0.05).The serum Asp level after treatment in the two groups was significantly lower than that before treatment,the GABA level was significantly higher than that before treatment,moreover the changes in the group A was more obvious(P<0.05).The incidence rates of atelectasis,ventricular arrhythmia,hypostatic pneumonia and venous thrombosis had no statistically significant difference between the two groups(P>0.05).Conclusion Early adopting the hyperbaric oxygen twice daily combined with subhypothermia therapy in treating the patients with sTBI has more significantly protective effect on the brain nervous function and can further improve the prognosis.
作者
印佳
吕远
方涛
蔡军
季海明
刘艺春
余坚
段晓春
左刚
YIN Jia;LV Yuan;FANG Tao;CAI Jun;JI Haiming;LIU Yichun;YU Jian;DUAN Xiaochun;ZUO Gang(Department of Neurosurgery,Affiliated Taixing Hospital,Yangzhou University/Taixing People′s Hospital,Taixing,Jiangsu 225400,China;Department of Hyperbaric Oxygen,Affiliated Taixing Hospital,Yangzhou University/Taixing People′s Hospital,Taixing,Jiangsu 225400,China;Department of Neurosurgery,Taicang Municipal People′s Hospital,Taicang,Jiangsu 215400,China)
出处
《重庆医学》
CAS
2021年第7期1187-1190,共4页
Chongqing medicine
关键词
重度颅脑外伤
高压氧
亚低温
剂量
脑神经功能
severe craniocerebral trauma
hyperbaric oxygen
mild hypothermia
doses
brain nerve function
