高压氧对重型颅脑损伤术后患者长期预后的影响

目的:探讨高压氧(HBO)对重型颅脑损伤开颅术后疗效及预后的影响。方法:重型颅脑损伤后行标准外伤大骨瓣开颅术后患者97例,术后接受HBO治疗3个月,按是否坚持完成HBO治疗分为完成组61例和未完成组36例。随访5年,观察2组并发癫痫的比率、癫痫发作周期、死亡人数、格拉斯哥昏迷量表(GCS)及生存质量指数(QLI)评分。结果:2组术后24h及术后3个月GCS评分均明显高于术前(P<0.05),术后3个月完成组GCS及QLI评分明显高于未完成组(P<0.05),完成组出现继发癫痫及死亡例数明显低于未完成组(P<0.05);癫痫患者发作周期明显长于未完成组(P<0.05)。结论:重型颅脑损伤患者行标准外伤大骨瓣开颅术后配合标准疗程的HBO治疗可明显降低继发癫痫的比率,提高生存质量。

Effect of hyperbaric oxygen on long-term outcome of patients in severe traumatic brain injury

Objective: To investigate the effect of hyperbaric oxygen(HBO) treating severe traumatic brain injury after craniotomy.Methods:97 patients of severe traumatic brain injury receiving standard large trauma craniotomy received hyperbaric oxygen and were divided into completed group(n=61)and no-completed group(n=36)according to whether completing hyperbaric oxygen treatment or not.In a follow-up visit of 5 years,incidence of posttraumatic seizure,GCS score and quality of life index(QLI) score of two groups were observed.Results: GCS score of two groups 24h and 3 months after operation were significantly higher than that of before(P<0.05).3 months after operation GCS and QLI scores in completed group were much higher than that of no-completed group(P<0.05).The incidence of posttraumatic seizure and death cases in completed group were significantly lower than that of no-completed group(P<0.05),and attack cycle was much longer than that of no-completed group(P<0.05).Conclusion: Giving standard large trauma craniotomy and hyperbaric oxygen therapy to patients of severe traumatic brain injury can significantly decrease the incidence of posttraumatic seizure and death,improve the quality of life.