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
2012年
4期
216-219
,共4页
高压氧%亚低温%重型颅脑外伤%并发症
高壓氧%亞低溫%重型顱腦外傷%併髮癥
고압양%아저온%중형로뇌외상%병발증
Hyperbaric oxygen%Mild hypothermia%Severe traumatic brain injury%Complications
目的 探讨高压氧(hyperbaric oxygen,HBO)联合亚低温治疗重型颅脑外伤的临床疗效及对并发症的影响.方法 将222例重型颅脑外伤患者经知情同意后按治疗方法分为HBO联合亚低温组(联合组,88例)、亚低温治疗组(亚低温组,60例)和HBO治疗组(HBO组,74例),以发病后1～11d为亚低温治疗时间,联合组与HB0组同时辅助HBO治疗,疗程结束后进行并发症发生率、临床治疗效果、3个月后格拉斯哥昏迷量表评分(GCS)、格拉斯哥预后量表评分(GOS)及6个月后远期生活质量评估量表评分(KPS)比较.结果 亚低温组肺部感染发生率(41.7％)和肾功能损害发生率(25.0％)与其他2组比较差异均有统计学意义(P＜0.05);联合组显效率(64.8％)和总有效率(93.2％)与其他2组比较差异均有统计学意义(P＜0.01);3个月后,联合组GCS与GOS明显高于其他2组(P＜0.05或P＜0.01).6个月后联合组KPS也明显高于其他2组(P＜0.05或P＜0.01).结论 HBO联合亚低温治疗重度颅脑外伤,能明显降低重度颅脑外伤患者致残率和死亡率,显著改善患者神经功能,明显改善预后.
目的 探討高壓氧(hyperbaric oxygen,HBO)聯閤亞低溫治療重型顱腦外傷的臨床療效及對併髮癥的影響.方法 將222例重型顱腦外傷患者經知情同意後按治療方法分為HBO聯閤亞低溫組(聯閤組,88例)、亞低溫治療組(亞低溫組,60例)和HBO治療組(HBO組,74例),以髮病後1～11d為亞低溫治療時間,聯閤組與HB0組同時輔助HBO治療,療程結束後進行併髮癥髮生率、臨床治療效果、3箇月後格拉斯哥昏迷量錶評分(GCS)、格拉斯哥預後量錶評分(GOS)及6箇月後遠期生活質量評估量錶評分(KPS)比較.結果 亞低溫組肺部感染髮生率(41.7％)和腎功能損害髮生率(25.0％)與其他2組比較差異均有統計學意義(P＜0.05);聯閤組顯效率(64.8％)和總有效率(93.2％)與其他2組比較差異均有統計學意義(P＜0.01);3箇月後,聯閤組GCS與GOS明顯高于其他2組(P＜0.05或P＜0.01).6箇月後聯閤組KPS也明顯高于其他2組(P＜0.05或P＜0.01).結論 HBO聯閤亞低溫治療重度顱腦外傷,能明顯降低重度顱腦外傷患者緻殘率和死亡率,顯著改善患者神經功能,明顯改善預後.
목적 탐토고압양(hyperbaric oxygen,HBO)연합아저온치료중형로뇌외상적림상료효급대병발증적영향.방법 장222례중형로뇌외상환자경지정동의후안치료방법분위HBO연합아저온조(연합조,88례)、아저온치료조(아저온조,60례)화HBO치료조(HBO조,74례),이발병후1～11d위아저온치료시간,연합조여HB0조동시보조HBO치료,료정결속후진행병발증발생솔、림상치료효과、3개월후격랍사가혼미량표평분(GCS)、격랍사가예후량표평분(GOS)급6개월후원기생활질량평고량표평분(KPS)비교.결과 아저온조폐부감염발생솔(41.7％)화신공능손해발생솔(25.0％)여기타2조비교차이균유통계학의의(P＜0.05);연합조현효솔(64.8％)화총유효솔(93.2％)여기타2조비교차이균유통계학의의(P＜0.01);3개월후,연합조GCS여GOS명현고우기타2조(P＜0.05혹P＜0.01).6개월후연합조KPS야명현고우기타2조(P＜0.05혹P＜0.01).결론 HBO연합아저온치료중도로뇌외상,능명현강저중도로뇌외상환자치잔솔화사망솔,현저개선환자신경공능,명현개선예후.
Objective To explore the therapeutic effect of HBO coupled with mild hypothermia on 88cases of severe traumatic brain injury and to study the effect of HBO on complications.Methods Two hundred and twenty-two cases of severe traumatic brain injury were divided into the HBO therapy coupled with mild hypothermia group ( or the combined group ),the mild hypothermia therapy group ( or the mild hypothermia group),and the HBO therapy group ( or the HBO group).Mild hypothermia treatment time was 1 to 11 days,after the onset of severe traumatic brain injury.Both the combined group and the HBO groups were given HBO therapy.Following treatment,the rate of complications,the therapeutic effects,the scores of Glasgow Coma Scale (GCS) after 3 months of treatment,the scores of Glasgow Outcome Scale (GOS) and scores of long-term Life Quality Assessment Scale after 6 months of treatment were compared and analyzed.Results The rate of pulmonary infection for the mild hypothermia group was 41.7％ and the rate of renal dysfunction accounted for 25.0％,and statistical differences could be seen,when they were compared with those of the other two groups ( P ＜ 0.05 ).For the combined group,significant therapeutic effect accounted for 64.8％,with a total effective rate of 93.2％,and statistical differences could be seen,when they were compared with those of the other 2groups (P ＜ 0.01 ).After 3 months of treatment,the scores of GCS and GOS of the combined group were significantly higher than those of the other 2 groups (P ＜0.05 or P ＜0.01 ).After 6 months of treatment,the scores of long-term Life Quality Assessment Scale of the combined group were also significantly higher than those of the other 2 groups ( P ＜ 0.05 or P ＜ 0.01 ).Conclusions HBO therapy combined with mild hypothermia could significantly decrease the morbidity and mortality,obviously improve the neurological function and considerably improve prognosis of patients with severe traumatic brain injury.
