中华航海医学与高气压医学杂志
中華航海醫學與高氣壓醫學雜誌
중화항해의학여고기압의학잡지
CHINESE JOURNAL OF NAUTICAL MEDICINE AND HYPERBARIC MEDICINE
2009年
3期
164-166
,共3页
向海斌%傅敏%张陆弟%赵晖
嚮海斌%傅敏%張陸弟%趙暉
향해빈%부민%장륙제%조휘
高压氧%并发症%预防
高壓氧%併髮癥%預防
고압양%병발증%예방
Hyperbaric oxygen therapy%Complications%Preventive effect
目的 探讨早期高压氧(HBO)治疗对重型颅脑损伤并发症的预防作用.方法 重型颅脑损伤患者326例,GCS评分≤8分,经专科会诊有HBO治疗指征,并排除禁忌证.其中234例在常规治疗同时给予HBO治疗,入院或颅脑手术2周内首次行HBO者为早期HBO组,共126例.入院或颅脑手术2周后首次行HBO者为晚期HBO组,共108例.另外,因各种原因未行HBO者92例作为对照组;3组病例在性别、年龄、GCS评分上的差异均无统计学意义.3组病例随访时间均为入院或手术始至以后8周.结果 早期HBO组肺部感染发生率与晚期HBO组比较差异有统计学意义(x2=13.78,P<0.01),晚期HBO组肺部感染发生率与对照组比较差异有统计学意义(x2=10.81,P<0.05).早期HBO组上消化道出血发生率与晚期HBO组比较差异有统计学意义(x2=7.32,P<0.01).早期HBO组肾功能损害发生率与晚期HBO组比较差异有统计学意义(x2=7.39,P<0.01).结论 早期HBO治疗对重度颅脑损伤常见的肺部感染、上消化道出血、肾功能损害等并发症的发生有显著的预防作用.
目的 探討早期高壓氧(HBO)治療對重型顱腦損傷併髮癥的預防作用.方法 重型顱腦損傷患者326例,GCS評分≤8分,經專科會診有HBO治療指徵,併排除禁忌證.其中234例在常規治療同時給予HBO治療,入院或顱腦手術2週內首次行HBO者為早期HBO組,共126例.入院或顱腦手術2週後首次行HBO者為晚期HBO組,共108例.另外,因各種原因未行HBO者92例作為對照組;3組病例在性彆、年齡、GCS評分上的差異均無統計學意義.3組病例隨訪時間均為入院或手術始至以後8週.結果 早期HBO組肺部感染髮生率與晚期HBO組比較差異有統計學意義(x2=13.78,P<0.01),晚期HBO組肺部感染髮生率與對照組比較差異有統計學意義(x2=10.81,P<0.05).早期HBO組上消化道齣血髮生率與晚期HBO組比較差異有統計學意義(x2=7.32,P<0.01).早期HBO組腎功能損害髮生率與晚期HBO組比較差異有統計學意義(x2=7.39,P<0.01).結論 早期HBO治療對重度顱腦損傷常見的肺部感染、上消化道齣血、腎功能損害等併髮癥的髮生有顯著的預防作用.
목적 탐토조기고압양(HBO)치료대중형로뇌손상병발증적예방작용.방법 중형로뇌손상환자326례,GCS평분≤8분,경전과회진유HBO치료지정,병배제금기증.기중234례재상규치료동시급여HBO치료,입원혹로뇌수술2주내수차행HBO자위조기HBO조,공126례.입원혹로뇌수술2주후수차행HBO자위만기HBO조,공108례.령외,인각충원인미행HBO자92례작위대조조;3조병례재성별、년령、GCS평분상적차이균무통계학의의.3조병례수방시간균위입원혹수술시지이후8주.결과 조기HBO조폐부감염발생솔여만기HBO조비교차이유통계학의의(x2=13.78,P<0.01),만기HBO조폐부감염발생솔여대조조비교차이유통계학의의(x2=10.81,P<0.05).조기HBO조상소화도출혈발생솔여만기HBO조비교차이유통계학의의(x2=7.32,P<0.01).조기HBO조신공능손해발생솔여만기HBO조비교차이유통계학의의(x2=7.39,P<0.01).결론 조기HBO치료대중도로뇌손상상견적폐부감염、상소화도출혈、신공능손해등병발증적발생유현저적예방작용.
Objective To explore preventive effect of early hyperbaric oxygen therapy (HBOT)on complications in severe craniocerebral injury patients.Methods Three hundred and twenty-six cases (244 were male,82 were female,with an average age of 36.2 ± 6.7 ) of severe eraniocerebral injury with Glasgow Coma Scale (GCS) score ≤ 8 were selected for the study.Specialist consultation showed that all had indications for HBOT,but no contraindieations for HBOT.Of all the cases,234 were given conventional treatment coupled with HBOT.Those who were given HBOT within two weeks following operations of cranium and brain were of the early HBOT group,totaling 126 cases.Those who were given HBOT two weeks after operations of cranium and brain were of the late HBOT group,totaling 108 cases.In addition,another 92 patients who were not given HBOT for one reason or other were used as contrast.No statistical differences could be seen in sex,age and GCS score.Clinical follow-up interval for the three groups was eight weeks (from the time of admission or operation to eight weeks).Results Incidence rate of pulmonary infection for the early HBOT group was significantly lower than that of the late HBOT group (x2 = 13.78,P < 0.01 ).Pulmonary infection incidence for the late HBOT group was obviously lower than that of the control group(x2 = 10.81,P < 0.05 ).Incidence rate of hemorrhage of digestive tract for the early HBOT group was significantly lower than that of the late HBOT group (x2 =7.32,P <0.01 ),and the rate of renal damage for the early HBOT group was significantly lower than that of the late HBOT group (x2 = 7.39,P < 0.01 ).Conclusions Early HBOT had obvious preventive effect on the following three complications: pulmonary infection,hemorrhage of upper digestive tract and renal damage in severe craniocerebral injury patients.
