脑挫裂伤伴脑疝形成术后高压氧治疗的临床疗效分析

目的:探讨高压氧治疗对脑挫裂伤伴脑疝形成术后患者神经功能康复及并发症发生的影响。方法:回顾性分析川北医学院附属医院近6年脑挫裂伤伴脑疝形成术后患者的病历资料,将符合要求的病例按照治疗过程中是否愿意接受高压氧治疗分为高压氧治疗组和对照组,对照组患者接受常规治疗,高压氧组患者在常规治疗基础上接受1个疗程以上的高压氧治疗。比较2组患者外伤性癫痫、脑积水、硬膜下积液的发生率及特定时间格拉斯哥昏迷评分(GCS)、格拉斯哥预后评分(GOC)评分。结果:155份病历资料被纳入统计,其中高压氧组85例,对照组70例。2组各发生外伤性癫痫7例,差异无统计学意义(χ 2=0.145, P=0.70);2组分别发生外伤性脑积水3例、9例,差异有统计学意义(χ 2=4.676, P=0.03);2组外伤性硬膜下积液分别出现8例、19例,差异有统计学意义(χ 2=8.390, P=0.004)。术后2周高压氧组GCS评分为(7.72±1.51)分,高于对照组的(7.26±1.13)分,差异有统计学意义( t=2.164, P=0.03);术后4周高压氧组GCS评分为(8.94±1.74)分,高于对照组的(8.08±1.48)分,差异有统计学意义( t=3.261, P=0.001)。术后6个月GOS评分高压氧组[(3.75±0.65)分]高于对照组[(3.16±0.79)分],差异有统计学意义( t=4.883, P<0.001)。 结论:脑挫裂伤伴脑疝形成术后高压氧治疗有助于降低脑积水和硬膜下积液的发生率,促进患者神经功能的恢复和生活质量的提高。

Clinical effect analysis of hyperbaric oxygen on postoperative patients with cerebral contusion and hernia

Objective To investigate the clinical effect of hyperbaric oxygen on the recovery of nervous function and complication occurrence of the postoperative patients with cerebral contusion and hernia.Methods The clinical data of postoperative patients with cerebral contusion and hernia in the Affiliated Hospital of North Sichuan Medical College in recent 6 years were analyzed retrospectively.All the cases met the criteria were then classified based on whether received hyperbaric oxygen into hyperbaric oxygen group(HBO group)and control group.The patients of the HBO group received more than one course of hyperbaric oxygen,while the patients of the control group received routine treatment.The incidences of traumatic epilepsy,traumatic hydrocephalus,subdural effusion,and the Glasgow coma score(GCS)and Glasgow outcome score(GOS)at specific time of the two groups were compared.Results Seven cases of traumatic epilepsy were observed in the HBO group and control group respectively.There was no significant difference of the incidence of traumatic epilepsy(χ2=0.145,P=0.70).Three cases of traumatic hydrocephalus were in the HBO group while 7 cases were in the control group.The difference between the two groups was statistically significant(χ2=4.676,P=0.03).Eight cases of subdural effusion were detected in the HBO group while 19 cases in the control group.The difference was statistically significant(χ2=8.390,P=0.004).The GCS score of the HBO group(7.72±1.51)was higher than that of the control group(7.26±1.13)with statistical significance two weeks after operation(t=2.164,P=0.03).The GCS score of the HBO group(8.94±1.74)was higher than that of the control group(8.08±1.48)with statistical significance four weeks after operation(t=3.261,P=0.001).Six months after operation,the GOS score of the HBO group(3.75±0.65)was higher than that of the control group(3.16±0.79)with statistical significance(t=4.883,P<0.001).Conclusion Hyperbaric oxygen can not only reduce the incidence of traumatic hydrocephalus and subdural effusion,but also promote the recovery of neural function and improve the life quality of the postoperative patients with cerebral contusion and hernia.