早期高压氧治疗对重型颅脑损伤常见并发症的预防作用

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.

Preventive effect of early hyperbaric oxygen therapy on complications in severe craniocerebral injury patients

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.