Xu Lanjuan, Li Baolin, Yang Caifu, Li Chengjian, Peng Yueli
Intensive Care Unit, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan Province, China.
Pak J Pharm Sci. 2016 Jan;29(1 Suppl):273-80.
In order to discuss the clinical efficacy of simulation hyperbaric oxygen therapy (HBOT) for severe craniocerebral injury and analyze the related factors of it, 108 patients who transferred to our department during December 2010 - December 2014 for ventilator treatment after operation of severe craniocerebral injury were taken as the subjects of the study. These patients were divided into conventional treatment group and simulation hyperbaric oxygen therapy group to contrast the curative effects. At the meantime, GOS score and length of stay in intensive care unit (ICU) of two groups 6 months after treatment, as well as changes in the indexes of the HBO group during treatment were performed statistical analysis. Then factors affecting prognosis of simulation HBOT were performed regression analysis and principal component analysis. The results showed that when compared to the control group, differences in cases with four GOS score and one GOS score in the treatment group were significant (p<0.05). Jugular venous oxygen saturation (SjvO2), jugular bulb oxygen partial pressure (PjO2), arterial partial pressure of oxygen (PaO2) and arterial oxygen saturation (SaO2) of the simulation HBO group before the first time treatment on the first day and after the first time treatment on the third day were significantly increased, with statistical significance (p<0.05); serum lactic acid (Lac) and blood glucose (Glu) decreased significantly (p<0.05). Prior to and during the first treatment on the first day, jugular bulb pressure (Pj) and central venous pressure (CVP) had no significant difference (p>0.05). Regression analysis indicated that factors affecting prognosis included cerebral contusion, coronary heart disease, hydrocephalus and tracheotomy. Principal component analysis found the factors were hydrocephalus, coronary heart disease, tracheotomy, cerebral contusion, cerebral infarction and glasgow coma scale (GCS) before treatment. Therefore, stimulation HBOT can significantly improve the prognosis of patients with severe craniocerebral injury. Paying attention to risk factors in clinics and giving timely interventional treatment can reduce morbidity and mortality in patients.
为探讨模拟高压氧疗法（HBOT）对重型颅脑损伤的临床疗效并分析其相关因素，选取2010年12月至2014年12月期间因重型颅脑损伤术后转入我科行呼吸机治疗的108例患者作为研究对象。将这些患者分为常规治疗组和模拟高压氧治疗组进行疗效对比。同时，对两组治疗6个月后的格拉斯哥预后评分（GOS）及重症监护病房（ICU）住院时间，以及高压氧组治疗期间各项指标的变化进行统计学分析。然后对影响模拟高压氧治疗预后的因素进行回归分析和主成分分析。结果显示，与对照组相比，治疗组GOS评分四级和一级的病例差异有统计学意义（p<0.05）。模拟高压氧组首次治疗前第1天和首次治疗后第3天的颈静脉血氧饱和度（SjvO2）、颈静脉球部氧分压（PjO2）、动脉血氧分压（PaO2）和动脉血氧饱和度（SaO2）均显著升高，差异有统计学意义（p<0.05）；血清乳酸（Lac）和血糖（Glu）显著降低（p<0.05）。首次治疗前第1天及治疗期间，颈静脉球部压力（Pj）和中心静脉压（CVP）差异无统计学意义（p>0.05）。回归分析表明，影响预后的因素包括脑挫裂伤、冠心病、脑积水和气管切开。主成分分析发现影响因素为脑积水、冠心病、气管切开、脑挫裂伤、脑梗死及治疗前格拉斯哥昏迷量表（GCS）评分。因此，模拟高压氧治疗能显著改善重型颅脑损伤患者的预后。临床关注危险因素并及时给予干预治疗可降低患者的发病率和死亡率。
