早期高压氧联合神经节苷脂治疗重型颅脑损伤临床研究

目的 探讨早期高压氧联合神经节苷脂治疗对重型颅脑损伤患者预后的影响.方法 将149例重型颅脑损伤患者随机分为3组,A组（早期高压氧组）48例,B组（神经节苷脂治疗组）50例,C组（早期高压氧＋神经节苷脂治疗组）51例.比较3组治疗前后格拉斯哥昏迷（Glasgow coma scale,GCS）评分、Barthel指数,治疗3个月后使用格拉斯哥预后评分（Glasgow outcome score,GOS）评价患者的预后.结果 治疗1周、2周后C组GCS评分显著高于A、B组（P〈0.01）.治疗3个月后A、B、C 3组Barthel指数分别为51.48±9.35、50.48±9.05、68.95±8.69,预后良好率分别为39.58%、42.00%、68.64%,死亡率分别为33.33%、34.00%、11.76%.C组Barthel指数、预后良好率显著高于A、B组（P〈0.01）,并且C组死亡率显著低于A、B组（P〈0.01）.结论 早期高压氧联合神经节苷脂治疗可以明显改善重型颅脑损伤患者神经功能及预后,提高患者的生存质量.

The clinical research of early hyperbaric oxygen combined ganglioside in the treatment of patients with severe traumatic brain injury

Objective To investigate the effect of early hyperbaric oxygen combined ganglioside therapy on prognosis in patients with severe traumatic brain injury.Methods 149 patients with severe traumatic brain injury were randomly divided into three groups,group A（early hyperbaric oxygen therapy group,n=48）,group B（ganglioside therapy group,n=50） and group C（combination therapy group,n=51）.Glasgow coma scale,the Barthel index of ADL and Glasgow outcome score were compared among the 3 groups after treatment.Results The scores of GCS in group C were significantly higher than those of group A and group B after 1 week and 2 weeks（P0.01）.The Barthel index of ADL in group C（68.95±8.69） was significantly higher than that in group A（51.48±9.35） and group B（50.48±9.05）,P0.01.Compared with group A（39.58%） and group B（42.00%）,the rate of good prognosis in group C（68.64%） was significantly higher after treatment（P0.01）,and the mortality rate in group C（11.76%） was significantly lower than that in group A（33.33%） and group B（34.00%）,P0.01.Conclusion Early hyperbaric oxygen combined ganglioside therapy can significantly promote the rehabilitation of the neurological function and prognosis in patients with severe traumatic brain injury,and may improve the patients＇ quality of life.