高压氧治疗颅脑损伤时机和剂量与疗效的关系.pdf
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1、SYSTEMS MEDICINE 系统医学系统医学 2023 年 9 月第 8 卷第 17 期 外科研究 高压氧治疗颅脑损伤时机和剂量与疗效的关系方明鑫,汤平南京市高淳中医院神经外科,江苏南京 211300摘要 目的 探究多人空气加压舱高压氧治疗颅脑损伤时机和剂量与疗效的关系。方法 选择2022年5月2023年5月南京市高淳中医院神经外科收治的72例颅脑损伤患者开展研究,按照不同治疗时机、剂量分组:A组、B组于发病5 d以内进行高压氧治疗,C组、D组于发病5 d后进行高压氧治疗,各组18例,其中A组高压氧治疗次数为 1次/d,B组高压氧治疗次数为 2次/d,C组高压氧治疗次数为 1次/d,D组
2、高压氧治疗次数为 2次/d,均为期半个月,对比两组患者临床总有效率,同时采用格拉斯哥预后(Glasgow Coma Scale,GCS)评分标准、颅脑外伤残疾评定量表(Disability Rating Scale,DRS)评价患者治疗前后损伤程度、伤残状况。结果 治疗半个月后,D组临床总有效率(94.44%)、B组临床总有效率(100.00%)较C组(61.11%)高,差异有统计学意义(P0.05);B组GCS评分较A组高,且D组GCS评分高于C组,B组GCS评分高于C组,差异有统计学意义(P0.05);B组DRS较A组低,且D组DRS均低于C组,B组、D组DRS均低于C组,差异有统计学意义
3、(P0.05)。结论 颅脑损伤患者采取高压氧治疗,可取得理想的临床疗效,尤其是发病后5 d以内进行2次/d的高压氧治疗,对其损伤程度及伤残状况的改善作用更明显,值得进行推广。关键词 颅脑损伤;高压氧;治疗时机;剂量;疗效;关系研究中图分类号 R4 文献标识码 A 文章编号 2096-1782(2023)09(a)-0147-04The Relationship between Timing,Dose and Efficacy of Hyperbaric Oxygen Therapy for Craniocerebral InjuryFANG Mingxin,TANG PingDepartmen
4、t of Neurosurgery,Nanjing Gaochun Hospital of Traditional Chinese Medicine,Nanjing,Jiangsu Province,211300 ChinaAbstract Objective To explore the relationship between the timing,dose and efficacy of multi-person air pressurized chamber hyperbaric oxygen treatment for craniocerebral injury.Methods 72
5、 patients with craniocerebral injury admitted to the Neurosurgery Department of Nanjing Gaochun Hospital of Traditional Chinese Medicine from May 2022 to May 2023 were selected for research.According to different treatment timing and dosage,groups A and B were treated with hyperbaric oxygen therapy
6、within 5 days of onset of illness,and groups C and D were treated with hyperbaric oxygen therapy 5 days after onset of illness,with 18 cases in each group.The number of hyperbaric oxygen treatments in group A was once a day,the number of hyperbaric oxygen treatments in group B was twice a day,the nu
7、mber of hyperbaric oxygen treatments in group C was once a day,and the number of hyperbaric oxygen treatments in group D was twice a day,all for half a month.The total clinical effectiveness of the two groups was compared,and the Glasgow coma scale(GCS)scoring standard and the craniocerebral trauma
8、disability rating scale(DRS)were used to evaluate the patients degree of injury and disability status before and after treatment.Results After half a month of treatment,the total clinical effective rate in group D(94.44%)and the total clinical effective rate in group B(100.00%)were higher than those
9、 in group C(61.11%),and the difference was statistically significant(P0.05).The GCS score of group B was higher than that of group A,the GCS score of group D was higher than that of group C,and the GCS score of group B was higher than that of group C,and the difference was statistically significant(
10、P0.05).The DOI:10.19368/ki.2096-1782.2023.17.147作者简介 方明鑫(1986-),男,本科,主治医师,研究方向为神经外科高压氧。通信作者 汤平(1985-),男,本科,副主任医师,研究方向为脑外伤、脑出血,E-mail:。147系统医学 2023 年 9 月第 8 卷第 17 期 外科研究 系统医学 SYSTEMS MEDICINEDRS of group B was lower than that of group A,and the DRS of group D was lower than that of group C.The DRS of
11、 groups B and D were lower than that of group C,and the difference was statistically significant(P0.05),具有可比性。本研究已获得南京市高淳中医院医学伦理委员会批准。1.2 纳入与排除标准纳入标准:认知障碍患者;结合临床表现、影像学检查等确诊为颅脑损伤患者;伤后 24 h 入院患者;存在高压氧治疗指征患者;患者家属知晓研究内容,并积极加入。排除标准:心理疾病者;占位性病变、重要脏器功能衰竭、凝血功能障碍等者;颅内活动性出血、持续性休克者;近期(3个月以内)口服影响凝血功能的药物治疗者;既往有脑
12、外伤史者。1.3 方法安排同一组工作经验丰富的医生对患者进行治疗。患者入院后,进行常规对症治疗,包括抗感染、补液、吸氧、营养支持、营养神经及脑细胞、甘露醇、亚低温治疗,另外分别于不同治疗时机予以不同剂量的高压氧治疗,即加压时间为 20 min,设定压力0.20.25 MPa,舱内氧浓度23%,控制氧浓度96%(纯氧)0.5 h,中途休息 5 min,再次氧浓度96%(纯氧)0.5 h,等速减压20 min,即可出舱。A组、B组于发病5 d及以内进行高压氧治疗,A组高压氧治疗次数为 1 次/d;B 组高压氧治疗次数为2次/d。C 组、D 组于发病 5 d 后进行高压氧治疗,C 组高压氧治疗次数为
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- 关 键 词:
- 高压 治疗 颅脑 损伤 时机 剂量 疗效 关系