Effects of early hyperbaric oxygen therapy on postoperative neurological function of severe craniocerebral injury patients

doi:10.3877/cma.j.issn.2095-9141.2015.03.002

Abstract

Abstract:

Objective

To investigate the effects of early hyperbaric oxygen treatment on patients with severe craniocerebral injury on the postoperative neurological function.

Methods

A total of seventy eight patients with severe traumatic brain injury in recovery period after surgical operation were selected for this study.According to the intervention time of hyperbaric oxygenation,they were randomly divided into early group(HBOT within 3 days after operation,n=38)and control group(HBOT without 7 days after operation,n=40).Dynamic head CT scan was performed for detecting and determine the duration of brain edema. Patients’ consciousness were assessed in 1, 2, 3, 4 weeks after the operation by GCS (Glasgow Coma Scale) and the neurological function were performed l, 2, 3 months after the operation by NIHSS (National Institutes of Health Stroke Scale).

Results

Compared with the control group (12.65±4.42) d, the duration of brain edema in early group (10.39 ±4.05) d was significantly reduced(P＜0.05). The GCS scores were (7.68±1.49), (9.38±1.51), (10.28±1.55), (11.13±1.68) after operation 1, 2, 3, 4 weeks in control group, respectively; and the early group were (8.63±1.28), (10.08±1.26), (11.03±1.31), (12.13±1.32), respectively. Compared with the control group, the GCS score in early group was significantly increased (P＜0.05). The NIHSS scores were(13.55±2.54), (9.05±2.46), (6.43±2.19) after operation 1, 2, 3 months in control group, respectively;and the early group were (12.05±2.09), (7.90±2.14), (5.24±1.98). Compared with the control group,the neurological defections were significantly reduced in early group (P＜0.05).

Conclusion

Early hyperbaric oxygen treatment on severe traumatic brain injury patients after surgery can shorten the duration of brain edema significantly, improve the state of consciousness and reduce the neurological function impairment.

Key words: Craniocerebral injury, Hyperbaric oxygenation, Brain edema, Glasgow coma scale

Longfei Shu, Caifen Zheng, Jinbiao Wang, Yongming Zhang, Xing Zhang, Chunlin Wang, Yanyan Yang, Tao Ma, Xiaolan Yang, Jiachuan Liu. Effects of early hyperbaric oxygen therapy on postoperative neurological function of severe craniocerebral injury patients[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2015, 01(03): 132-135.

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URL: https://zhsjcswkdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-9141.2015.03.002

https://zhsjcswkdzzz.cma-cmc.com.cn/EN/Y2015/V01/I03/132

Figures/Tables 5

分组	例数	年龄(岁)	性别(例)		GCS评分	瞳孔散大(例)			脑挫裂伤(例)	颅内血肿(例)	弥漫性轴索损伤(例)
分组	例数	年龄(岁)	男	女	GCS评分	单	双	无	脑挫裂伤(例)	颅内血肿(例)	弥漫性轴索损伤(例)
对照组	40	41.7±15.0	24	16	5.78±1.42	15	12	13	17	13	10
早期组	38	40.6±14.0	25	13	5.76±1.55	14	13	11	18	10	10

分组	例数	脑水肿持续时间(例)				平均持续时间(d， $\bar{x}$ ±s)
分组	例数	3～7d	8～12d	13～17d	18d以上	平均持续时间(d， $\bar{x}$ ±s)
早期组	38	11	17	7	3	10.39±4.05
对照组	40	7	13	12	8	12.65±4.42^a

分组	例数	脑水肿持续时间(例)				平均持续时间(d， $\bar{x}$ ±s)
分组	例数	3～7d	8～12d	13～17d	18d以上	平均持续时间(d， $\bar{x}$ ±s)
早期组	38	11	17	7	3	10.39±4.05
对照组	40	7	13	12	8	12.65±4.42^a

分组	例数	术后GCS评分				F值	P值
分组	例数	1周	2周	3周	4周	F值	P值
对照组	40	7.675±1.492	9.375±1.514^a	10.28±1.552^ab	11.13±1.682^abc	43.198	0.028
早期组	38	8.632±1.282	10.08±1.26^a	11.03±1.305^ab	12.13±1.319^abc	55.281	0.041
t值		3.030	2.226	2.308	2.931
P值		0.000	0.000	0.000	0.000

分组	例数	术后NIHSS评分			F值	P值
分组	例数	1月	2月	3月	F值	P值
对照组	40	13.55±2.541	9.05±2.459^a	6.425±2.194^ab	25.298	3.221
早期组	38	12.05±2.092	7.895±2.141^a	5.237±1.979^ab	56.882	0.012
t值		37.281	42.900	67.019
P值		4.290	3.765	0.045

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