| 马 亮,裴荣权,李立新,刘春波,张永明.早期高压氧联合去骨瓣减压治疗重型颅脑损伤的疗效及对患者神经功能、炎性因子的影响[J].,2023,(10):1889-1893 |
| 早期高压氧联合去骨瓣减压治疗重型颅脑损伤的疗效及对患者神经功能、炎性因子的影响 |
| Effect of Early Hyperbaric Oxygen combined with Decompressive Craniectomy on Severe Craniocerebral Injury and Its Effect on Neurological Function and Inflammatory Factors |
| 投稿时间：2022-09-04 修订日期：2022-09-28 |
| DOI：10.13241/j.cnki.pmb.2023.10.015 |
| 中文关键词: 重型 颅脑损伤 早期高压氧 去骨瓣减压 神经功能 炎性因子 |
| 英文关键词: Heavy Craniocerebral injury Early hyperbaric oxygen Decompressive craniectomy Neurological function Inflammatory cytokines |
| 基金项目:中央军委后勤保障部卫生局项目（12XL101) |
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| 中文摘要: |
| 摘要 目的：分析早期高压氧联合去骨瓣减压治疗重型颅脑损伤的疗效及对患者神经功能、炎性因子的影响。方法：选择我院自2018年1月至2021年10月接诊的106例重型颅脑损伤患者，随机分为对照组和观察组，各53例。两组均予以常规对症支持治疗，在此基础上，对照组采取去骨瓣减压治疗，观察组采取早期高压氧联合去骨瓣减压治疗。随访3个月，比较两组治疗前后的脑代谢指标、Fugl-Meyer运动功能评分、神经功能指标、炎性因子、严重并发症发生率及近期疗效。结果：观察组治疗后脑氧摄取率（CEO2）、混合静脉血氧饱和度（SVO2）均高于对照组（P＜0.05）；观察组治疗后上肢、下肢及总体Fugl-Meyer运动功能评分均高于对照组（P＜0.05）；观察组治疗后血清脑源性神经营养因子（BDNF）、神经元特异性烯醇化酶（NSE）、S100β蛋白、胶质纤维酸性蛋白（GFAP）水平均低于对照组，神经生长因子（NGF）水平高于对照组（P＜0.05）；观察组治疗后血清C反应蛋白（CRP）、白介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）均低于对照组（P＜0.05）；观察组严重并发症发生率低于对照组，预后良好率高于对照组（P＜0.05）。结论：早期高压氧联合去骨瓣减压治疗重型颅脑损伤的疗效显著，能够有效优化患者神经功能，抑制炎症反应，促进肢体运动功能恢复，进而改善预后，值得临床予以重视。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the effect of early hyperbaric oxygen combined with decompressive craniectomy on severe craniocerebral injury and its effect on neurological function and inflammatory factors. Methods: A total of 106 patients with severe craniocerebral injury admitted to our hospital from January 2018 to October 2021 were selected and randomly divided into matched group and observation group, 53 cases in each group. On this basis, the matched group was treated with decompressive craniectomy, and the observation group was treated with early hyperbaric oxygen combined with decompressive craniectomy. The brain metabolism index, Fugl-Meyer motor function score, neurological function index, inflammatory factors, incidence of serious complications and short-term efficacy were compared between the two groups before and after treatment for 3 months. Results: After treatment, the cerebral oxygen uptake rate(CEO2) and mixed venous oxygen saturation(SVO2) of the observation group were higher than those of the matched group (P<0.05). After treatment, the upper limb, lower limb and total Fugl-Meyer motor function scores of the observation group were higher than those of the matched group(P<0.05). After treatment, the levels of brain-derived neurotrophic factor (BDNF), neuronal specific enolase(NSE), S100β protein and glial fibrillary acidic protein(GFAP) in the observation group were lower than those in the matched group, and the levels of nerve growth factor(NGF) were higher than those in the matched group (P<0.05). The serum levels of C-reactive protein (CRP), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the observation group after treatment were lower than those in the matched group(P<0.05). The incidence of serious complications in the observation group was lower than that in the matched group, and the good prognosis rate was higher than that in the matched group (P<0.05). Conclusion: Early hyperbaric oxygen combined with decompressive craniectomy is effective in the treatment of severe craniocerebral injury, it can effectively optimize the neurological function of patients, inhibit inflammation, promote the recovery of limb motor function, and improve the prognosis, which is worthy of clinical attention. |
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