标题：颅脑外伤患者不同高压氧介入治疗时机与疗效比较

      作者：黄良珍，符传艺，李庆志，王鹏程
    (海南省人民医院神经外科，海南 海口 570311)

      卷次： 2016年27卷19期

      【摘要】 目的 比较不同时机介入高压氧治疗颅脑外伤的临床效果及预后。方法 将2013年7月至2016年
2月我院收治的 130例颅脑外伤患者，依据入院治疗的顺序将其分为观察组 67例和对照组 63例。观察组患者于
伤后 8~12 d开始接受高压氧治疗，对照组则在伤后 16~30 d后开始接受同样的高压氧治疗，治疗时间均为 1个
月。比较两组患者的临床疗效、苏醒时间、住院时间及病死情况，同时于治疗后比较两组患者的严重颅脑外伤残
疾评定量表(DRS)及格拉斯哥预后评分(GOS评分)。结果 观察组患者的治疗总有效率为95.52% (64/67)，明显高
于对照组的84.13% (53/63)，差异有统计学意义(P<0.05)；观察组患者的苏醒时间和住院时间分别为(18.65±3.16) d、
(51.63±3.25) d，均明显低于对照组的(23.74±4.38) d和(69.24±5.18) d，差异均有统计学意义(P<0.05)；观察组患者的
重残率和死亡率分别为2.99% (2/67)、1.49% (1/67)，均略低于对照组的7.94% (5/63)和4.76% (3/63)，但两组比较差异
均无统计学意义(P>0.05)；治疗结束后，观察组患者的DRS评分为(15.68±1.82)分，明显低于对照组的(17.13±2.11)分，
其GOS评分为(4.26±1.13)分，明显高于对照组的(3.75±0.86)分，差异均有显著统计学意义(P<0.01)。结论 颅脑外
伤患者在病情稳定的情况下，尽早开展高压氧介入治疗能够显著提高其临床疗效及预后，缩短苏醒、住院时间，使
其生活质量得到进一步改善，值得积极推广。

      【关键词】 颅脑外伤；高压氧；治疗时机；疗效；预后

      【中图分类号】 R651.1+5 【文献标识码】 A 【文章编号】 1003—6350（2016）19—3161—03


Comparison of curative effect and intervention time in different hyperbaric oxygen therapy for traumatic brain
injury.
HUANG Liang-zhen, FU Chuan-yi, LI Qing-zhi, WANG Peng-cheng. Department of Neurosurgery, Hainan
Provincial People's Hospital, Haikou 570311, Hainan, CHINA

【Abstract】 Objective To compare the curative effect and intervention time in different hyperbaric oxygen
therapy for traumatic brain injury. Methods A total of 130 cases of patients with craniocerebral trauma, who admit-
ted to our hospital from July 2013 to February 2016, were included in the study and divided into the observation
group (n=67) and the control group (n=63) according to the order of hospitalization. The patients in the observation
group were treated with hyperbaric oxygen after 8~12 d, while the control group received the same hyperbaric oxygen
therapy after 16~30 d, for 1 month. The clinical efficacy, recovery time, hospitalization and mortality of the two groups
were compared. After treatment, DRS (disability rating scale) and GOS (Glasgow Outcome Scale) score of the two
groups of patients were compared. Results The total effective rate of the observation group 95.52% (64/67) was sig-
nificantly higher than that of the control group of 84.13% (53/63), P<0.05. The recovery time and hospitalization time
in the observation group ((18.65 ± 3.16) d, (51.63 ± 3.25) d were significantly lower than those in the control group
((23.74±4.38) d, (69.24±5.18) d, P<0.05). The mortality rate and mortality rate of the observation group were 2.99%
(2/67) and 1.49% (1/67), respectively, which were slightly lower than those of the control group of 7.94% (5/63) and
4.76% (3/63), but the differences between the two groups were not statistically significant (P>0.05). Before the treat-
ment, DRS and GCS score of the two groups of patients had no significant difference (P>0.05). After the treatment,
DRS scores of the observation group (15.68±1.82) was significantly lower than that of the control group of (17.13±
2.11), P<0.01, and GCS score of the observation group (4.26±1.13) was significantly higher than that of the control
group of (3.75±0.86), P<0.01. Conclusion For the patients with craniocerebral trauma, in the case of stable condi-
tion, to carry out hyperbaric oxygen intervention as soon as possible can significantly improve the clinical efficacy
and prognosis, shorten the recovery time and hospitalization time, and improve the quality of life, which is worth to
be popularized.

      【Key words】 Traumatic brain injury; Hyperbaric oxygen intervention; Opportunity of therapy; Curative effect;
Prognosis
·论 著·doi:10.3969/j.issn.1003-6350.2016.19.022
基金项目：海南省自然科学基金(编号：20158349)