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rabbit8888

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早期HBO治疗重型颅脑外伤疗效及抗感染作用的临床研究
[摘要]目的:探讨早期高压氧(HBO)综合治疗对重型颅脑外伤患者脑功能康复的临床疗效及抗感染作用。方法:将重型颅脑外伤患者随机分成2组,治疗组68例,神经外科治疗、综合治疗的基础上行早期高压氧治疗;同期常规治疗组68例,行神经外科常规治疗、综合治疗。比较2组患者治疗前后格拉斯哥昏迷量表(GCS)评分变化情况,并于治疗后3、6、9个月进行格拉斯哥预后量表(GOS)评定;同时分别比较两组治疗前后感染发生率及伤后1w、2w、3w、4w外周血白细胞变化情况。结果:1. 治疗前两组GCS差异无统计学意义(P>0.05),治疗后两组GCS差异有统计学意义(P<0.05)。2、治疗前两组GOS评定差异无统计学意义(P>0.05),治疗后两组GOS评定差异有统计学意义(P<0.05)。3、治疗组感染发生率较低,特别是呼吸道、皮肤感染发生率差异有统计学意义(P<0.05);伤后1w两组患者WBC较正常值高,但差异无统计学意义(P>0.05);伤后2、3、4w,治疗组WBC较对照组低,差异有统计学意义(P<0.05);伤后3、4w治疗组WBC恢复正常值范围。结论:重型颅脑损伤患者在神经外科常规治疗、综合治疗的基础上结合早期HBO治疗能提高恢复良好率,降低死亡率和感染率,明显改善患者的生存质量。
[关键词] 高压氧;颅脑损伤;GCS;GOS ;WBC;感染率
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真强必胜: 金币+1, good 2013-12-24 21:25:35
Studies of the clinical efficacy  of early HBO treatment in severe traumatic brain injury and its' effects in anti-infection   
Abstract
Objective
To explore clinical efficacy and anti-infection effects of hyperbaric oxygen (HBO) for comprehensive treatment of brain function  rehabilitation in patients with severe traumatic brain injury .
Methods
Patients with severe traumatic brain injury were randomly divided into two groups, the (HBO) treatment group of 68 patients with neurosurgery treatment, comprehensive treatment  and early hyperbaric oxygen therapy; the conventional treatment group of 68 patients underwent conventional neurosurgery treatment and comprehensive treatment.Two groups were compared with Glasgow Coma Scale (GCS) score changes before and after treatment , and Glasgow Outcome Scale (GOS) assessment at 3,6,9 months after treatment . The incidence of wound infection and leukocytes changes in peripheral blood   after 1w, 2w, 3w, 4w of the  injury  of  the two groups were compared before and after treatment.
Results:
1 Before treatment GCS showed  no significant difference (P> 0.05), GCS difference between the two groups after treatment was statistically significant (P <0.05).2, GOS assessment before treatment groups showed no significant difference (P> 0.05).After treatment, both groups were statistically significant differences by GOS assessment (P <0.05).3, lower  infection in the treatment group, especially respiratory. Skin infection rate was significantly (P <0.05) between the (HBO) treatment group and  the conventional treatment group ;  patients WBC after injury  of 1w were higher than normal, but the difference was not statistically significant (P> 0.05); after injury of 2,3,4 w, WBC  of treatment group compared with the control group, the difference was statistically significant (P <0.05);  WBC of treatment group after injury of 3,4 w WBC became normal .
Conclusion
Patients with severe brain injury in conventional   neurosurgery  treatment, combined with comprehensive treatment and  early HBO therapy can improve  recovery rate, lower mortality and infection rates, and significantly improve the quality of life of patients.
Keyword
hyperbaric oxygen; traumatic brain injury; GCS; GOS; WBC; infection rate
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2楼2013-11-25 21:14:00
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rabbit8888

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3楼2013-12-26 08:55:44
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