开颅术联合高压氧对重型颅脑损伤患者昏迷指数的影响

目的探讨开颅术联合高压氧对重型颅脑损伤患者昏迷指数的影响。方法选择2009年1月—2011年10月在我院住院治疗的60例重型颅脑损伤患者,按照随机数字表法将患者分为对照组和观察组,每组30例。在常规药物治疗基础上,对照组采用开颅术治疗,观察组采用开颅术联合高压氧治疗,术后对两组患者的临床疗效、昏迷指数(Glasgow comascale,GCS)评分,并与高压氧治疗前、治疗4周及治疗3个月随访时治疗结果分级(GOS)进行对比分析。结果观察组和对照组临床有效率分别为86.67%(26/30)和76.67%(23/30),两组患者临床有效率比较差异有显著性(P<0.05);高压氧治疗后1周GCS评分无明显差异,第2、3、4周高压氧治疗后GCS评分比较有统计学差异(P<0.05);两组患者第4周、3个月随访阶段的GOS预后评分比较有统计学意义(P<0.05)。结论开颅术联合高压氧治疗不仅对重型颅脑损伤患者早期意识改善和预后有显著效果,而且提高了患者的生活质量,可以促使患者早日康复。

The Effect of Craniotomy and Hyperbaric Oxygen for GCS of Patients with Severe Traumatic Brain Injury

OBJECTIVE To investigate the impact of the craniotomy and hyperbaric oxygen for severe traumatic brain injury patients with （Glasgow comascale, GCS）. METHODS 60 cases of severe head injury patients in our hospital in January 2009 to 2011 in October, according to the random number table, patients were divided into control group and observation group, 30 cases in each group. Craniotomy for treating conventional drug treatment on the basis of the control group, the observation group with craniotomy and hyperbaric oxygen therapy after surgery, the clinical efficacy of the two groups of patients, the GCS score and hyperbaric oxygen therapy before Glasgow in the treatment of the results of classification（GOS）, 4 weeks of treatment, treatment of 3 month followup were analyzed. RESULTS The results of the observation group and control group, the clinical efficiency were 86.67%（26/30） and 76.67%（23/30）, two groups of patients with clinical efficiency difference between the difference（P〈0.05）, one week after the hyperbaric oxygen therapy no significant difference in GCS score, GCS score after the 3rd, 4th weeks of hyperbaric oxygen therapy, there is statistical difference（P〈0.05）, two groups of patients 4 weeks, 3 months follow-up phase of the GOS outcome score was statistically difference（P〈0.05）. CONCLUSION craniotomy hyperbaric oxygen not only for severe traumatic brain injury in patients with early awareness to improve prognosis had a significant effect, but also to improve the quality of life of patients, can promote patient recovery.