早期高压氧联合依达拉奉对颅脑外伤患者血管活性因子的影响及疗效

目的：研究重型颅脑损伤患者高压氧（HBO）联合依达拉奉治疗重型脑外伤后NO、ET的变化，并观察治疗效果。方法随机选取30例符合标准的急性重度颅脑外伤患者作为治疗组，同时随机抽取符合标准的30例患者作为对照组，予常规治疗。治疗组在常规治疗的基础上，给予早期高压氧治疗，并予依达拉奉静滴，30 mg/d，共用28 d，于伤后1 d、4 d、14 d用放射免疫法检测血浆NO-1、ET结果的变化。伤后3个月行预后判断GOS评分比较。结果治疗组和对照组治疗前血浆指标差异无统计学意义（P＞0.05），治疗后4 d、14 d，两组数据差异均有统计学意义（P＜0.01），且治疗组患者GOS评分明显好于对照组。结论高压氧联合依达拉奉治疗能有效降低颅脑外伤患者血清NO、ET的数值，改善颅脑外伤的血液流变，从而改善患者预后。

Clinical Analysis of the Curative Effect of Hyperbaric Oxygenation Combined with Edaravone on Serum NO,ET in Patients with Heavy Craniocerebral Injury

Objective To investigate the effects of hyperbaric oxygen treatment combined with edaravone on endothelin （ET） and NO in serum of patients with severe traumatic brain injury and its clinical signiifcance. Meth-ods To select 60 cases patients of heavy craniocerebral injury with GCS score of 3～8. 30 patients （therapy group） were treated by hyperbaric oxygen treatment and edaravone besides the conventional therapy：dewatering, hemo-stasis, advancing consciousness, pressing down the gastric acid excretion, trophicing nerve, expanding blood ves-sel and so on. And other 30 patients （control group） were treated by conventional therapy. The dynamic changes of serum ET-1 and NO at days 1, 4 and 14 respectively after trauma were monitored using ELISA. Then analyzing these data by statistical methods. Results Levels of serum ET-1 and NO increased more signiifcantly in the control group than those in the therapy group （P〈0.05）. The effect of hyperbaric oxygenation treatment combined with edaravone on heavy craniocerebral injury is better than the effect of conventional therapy. These methods have statistical differences. Conclusion The treatment of hyperbaric oxygen combined with edaravone can regulate se-rum cytokines levels in patients with severe brain injury, suppress the immune damage and improve the prognosis.