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早期亚低温结合后期高压氧治疗重度颅脑创伤的疗效分析

胡群亮   

  1. 武警后勤学院附属医院
  • 收稿日期:2011-12-13 修回日期:2012-04-01 出版日期:2012-08-15 发布日期:2012-08-15
  • 通讯作者: 胡群亮

A clinical research on combination of mild hypothermia and hyperbaric oxygen following by severe traumatic brain injury

  • Received:2011-12-13 Revised:2012-04-01 Published:2012-08-15 Online:2012-08-15

摘要: 【摘要】 目的 探讨亚低温结合高压氧在急性重度闭合性颅脑创伤中的治疗效果。方法 157 例急性重型颅脑创伤病人,随机分为亚低温组(54例)、亚低温加高压氧组(48例)和常规治疗组(55例)。治疗后3 个月根据格拉斯哥预后评分(GOS)标准判定疗效。对于除植物生存和死亡以外的101例病人,同时采用Barthel 指数,评估治疗后3个月病人的日常生活活动能力(Activities of daily Living, ADL),同时观察治疗过程中3组病人的并发症等情况。结果 亚低温组和亚低温结合高压氧组的病死率和常规治疗组相比有统计学意义(P<0.05),二者之间差异不明显(P>0.05)。3组的恢复良好率均有统计学意义(P<0.05),亚低温加高压氧组良好率最高。亚低温组和亚低温加高压氧组的Barthel指数分别和常规治疗组相比差异有统计学意义(P<0.01),亚低温和亚低温加高压氧组的Barthel指数相比亦有统计学意义(P<0.01)。结论早期应用亚低温治疗急性重型颅脑创伤可降低病人病死率,同时后期给予高压氧治疗可以提高病人恢复良好率,二者结合的疗法是一种有希望的颅脑外伤综合治疗措施。

关键词: 亚低温, 颅脑创伤, 高压氧

Abstract: 【Abstract】Objective To assess the clinical effects of mild hypothermia and hyperbaric oxygen injection following by severe traumatic brain injury. Methods According all 157 patients with acute severe traumatic brain injury were divided into mild hypothermia group (54 patients), hyperbaric oxygen with mild hypothermia group (48 patients) and routine treatment group (55 patients) randomly. The therapeutic effect was evaluated at the 3rd month after injury by Glascow Outcome Scale (GOSs). One hundred and one patients (vegetable alive and dead patients were not included) were evaluated at the 3rd month after injury by Barthel Index. Result In comparison with other two groups, there was a higher mortality rate in routine treatment group (P<0.05). There were significant difference for recovery rate in three groups (P<0.05). Conclusions Mild hypothermia was an effective way to severe traumatic brain injury, which could reduce the mortality rate and improve the prognosis without severe complications. The hyperbaric oxygen injection had some effect for recovery.

Key words: Mild hypothermia, Traumatic brain injury, Hyperbaric oxygen