高压氧治疗脑外伤的疗效及对外周血CD34~+的影响
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摘要
目的:探究高压氧治疗脑外伤的疗效及对外周血CD_34~+的影响。方法:选取2017年6月1日-2018年6月1日在本院诊断及治疗的脑外伤患者80例,采用随机数表法分为观察组与对照组,每组各40例,对照组采用常规脑外伤及支持治疗,观察组在对照组的基础上予以高压氧治疗。对比两组治疗疗效及GOS分级,治疗前后GCS、DRS及外周血CD_34~+水平。结果:观察组治疗总有效率82.50%显著高于对照组60.00%,两组比较差异有统计学意义(χ~2=4.942,P=0.026)。治疗后观察组GCS评分显著高于对照组(t=5.221,P=0.000),且GOS分级>Ⅳ级例数显著高于对照组(χ~2=14.459,P=0.000)。治疗后观察组DRS评分显著低于对照组(t=2.822,P=0.000)。治疗后第3～11天观察组CD_34~+水平显著高于治疗前(P<0.05),且高于同时期对照组(P<0.05)。结论:高压氧治疗脑外伤疗效肯定,且能有效提高外周血CD_34~+水平。
Objective:To explore the effect of hyperbaric oxygen on brain injury and CD_34~+ in peripheral blood.Method:From June 1,2017 to June 1,2018,80 cases of cerebral trauma patients diagnosed and treated in our hospital were randomly divide into observation group( 40 cases) and control group( 40 cases).The control group was treated with conventional therapy,the observation group was treated with hyperbaric oxygen on the basis of control group.The efficacy,GOS,GCS,DRS and CD_34~+ in peripheral blood before and after treatment of twogroups were compared.Result:The total therapeutic efficiency of the observation group was82.50% significantly higher than control group of 60.00%( χ~2=4.942,P=0.026).After treatment,the GCS score of the observation group was significantly higher than that of control group(t=5.221,P=0.000),the number of GOS>Ⅳ level was significantly higher than that of control group( χ~2=14.459,P=0.000).The DRS score of the observation group was significantly lower than control group(t=2.822,P=0.000).After treatment 3-11 d,the CD_34~+ level in observation group was significantly higher than that before treatment(P<0.05),it was significantly higher than that of the control group in the same period(P<0.05).Conclusion:Hyperbaric oxygen treatment of brain trauma is effective and can effectively improve the level of CD_34~+ in peripheral blood
Objective:To explore the effect of hyperbaric oxygen on brain injury and CD_34~+ in peripheral blood.Method:From June 1,2017 to June 1,2018,80 cases of cerebral trauma patients diagnosed and treated in our hospital were randomly divide into observation group( 40 cases) and control group( 40 cases).The control group was treated with conventional therapy,the observation group was treated with hyperbaric oxygen on the basis of control group.The efficacy,GOS,GCS,DRS and CD_34~+ in peripheral blood before and after treatment of twogroups were compared.Result:The total therapeutic efficiency of the observation group was82.50% significantly higher than control group of 60.00%( χ~2=4.942,P=0.026).After treatment,the GCS score of the observation group was significantly higher than that of control group(t=5.221,P=0.000),the number of GOS>Ⅳ level was significantly higher than that of control group( χ~2=14.459,P=0.000).The DRS score of the observation group was significantly lower than control group(t=2.822,P=0.000).After treatment 3-11 d,the CD_34~+ level in observation group was significantly higher than that before treatment(P<0.05),it was significantly higher than that of the control group in the same period(P<0.05).Conclusion:Hyperbaric oxygen treatment of brain trauma is effective and can effectively improve the level of CD_34~+ in peripheral blood
引文
[1]岳立锋,刘艳丽,陈涛,等.重型颅脑损伤患者预后的影响因素分析[J].山西医药杂志,2015,44(11):1309-1311.
[2]肖承年,梁海山,黄鹏,等.脑外伤性癫痫治疗中单唾液酸四己糖神经节苷脂钠的临床价值[J].当代医学,2015,21(23):117-118.
[3]邹玲莉,张明月,张舜,等.高压氧预处理对急性高海拔暴露人体血清白细胞介素-6和基质金属蛋白酶-9的影响[J].中华航海医学与高气压医学杂志,2015,22(1):8-11.
[4]郑金荣,金华君,林君挺,等.外周血CD34+细胞与脑外伤患者预后关系的临床研究[J].中国临床药理学杂志,2014,30(3):171-172.
[5]万年亮,全柳霞.高压氧辅助治疗脑外伤疗效分析[J].深圳中西医结合杂志,2016,26(19):107-109.
[6]Bezdicek O,Michalec J,Nikolai T,et al.Clinical Validity of the Mattis Dementia Rating Scale in Differentiating Mild Cognitive Impairment in Parkinson’s Disease and Normative Data[J].Dementia&Geriatric Cognitive Disorders,2015,39(5-6):303-311.
[7]Mcmillan T,Wilson L,Ponsford J,et al.The Glasgow Outcome Scale-40 years of application and refinement[J].Nat Rev Neurol,2016,12(8):477-485.
[8]俞梦瑾,刘锦,孙冬玮,等.黄芪治疗重型颅脑损伤后脑水肿及颅内高压的疗效观察[J].中西医结合心脑血管病杂志,2016,14(12):1331-1334.
[9]刘显胜,秦献魁,高钰琪.高压氧治疗对急性高原病的应用与发展探析[J].中华航海医学与高气压医学杂志,2016,23(3):252-254.
[10]张源,张文进,田毅,等.大鼠创伤性颅脑损伤程度与血清MCP-1、VEGF及损伤区CD34+细胞表达水平的关系[J].中华神经医学杂志,2014,13(3):224-228.
[11]Wei X E,Li Y H,Zhao H,et al.Quantitative evaluation of hyperbaric oxygen efficacy in experimental traumatic brain injury:an MRI study[J].Neurol Sci,2014,35(2):295-302.
[12]冯康,文斌,问肃生.常压高浓度氧对创伤性颅脑损伤神经保护作用的研究进展[J].国际神经病学神经外科学杂志,2014,41(1):69-73.
[13]彭娟,周宏珍,史蕾,等.两种意识评估量表应用于神经外科患者中的信度和效度比较研究[J].中国实用护理杂志,2015,31(35):2672-2675.
[14]刘兵,马笑宇,杨晓辉,等.早期高压氧治疗对脑出血术后患者神经功能恢复的影响[J].现代中西医结合杂志,2015,24(19):2088-2090.
[15]花芸,戎天艺,陈贇,等.高压氧与神经变性疾病的相关性[J].中国实用神经疾病杂志,2017,20(21):111-113.
[16]苏美,孙德举.高压氧早期干预对缺氧缺血性脑病新生儿行为神经评分及智能发育的影响[J].中国医药科学,2016,6(6):34-36.
[17]Hung R,Carroll LJ,Cancelliere C,et al.Systematic review of the clinical course,natural history,and prognosis for pediatric mild traumatic brain injury:results of the International Collaboration on Mild Traumatic Brain Injury Prognosis[J].Archives of Physical Medicine&Rehabilitation,2014,95(3):S174-S191.
[18]王鹏先.高压氧早期综合治疗对重度颅脑外伤疗效的影响分析[J].世界最新医学信息文摘,2016,16(42):49.
[19]张月荣,郑海林,杨玉玲,等.高压氧治疗大脑中动脉梗塞侧肢循环的影响作用[J].中国医学装备,2014,14(s2):20.
[20]吴琼,翁其彪,梁凤娟.早期高压氧治疗对急性脑梗死患者脑血流灌注状态的影响及预后的临床研究[J].现代诊断与治疗,2015,20(11):2588-2589.
[2]肖承年,梁海山,黄鹏,等.脑外伤性癫痫治疗中单唾液酸四己糖神经节苷脂钠的临床价值[J].当代医学,2015,21(23):117-118.
[3]邹玲莉,张明月,张舜,等.高压氧预处理对急性高海拔暴露人体血清白细胞介素-6和基质金属蛋白酶-9的影响[J].中华航海医学与高气压医学杂志,2015,22(1):8-11.
[4]郑金荣,金华君,林君挺,等.外周血CD34+细胞与脑外伤患者预后关系的临床研究[J].中国临床药理学杂志,2014,30(3):171-172.
[5]万年亮,全柳霞.高压氧辅助治疗脑外伤疗效分析[J].深圳中西医结合杂志,2016,26(19):107-109.
[6]Bezdicek O,Michalec J,Nikolai T,et al.Clinical Validity of the Mattis Dementia Rating Scale in Differentiating Mild Cognitive Impairment in Parkinson’s Disease and Normative Data[J].Dementia&Geriatric Cognitive Disorders,2015,39(5-6):303-311.
[7]Mcmillan T,Wilson L,Ponsford J,et al.The Glasgow Outcome Scale-40 years of application and refinement[J].Nat Rev Neurol,2016,12(8):477-485.
[8]俞梦瑾,刘锦,孙冬玮,等.黄芪治疗重型颅脑损伤后脑水肿及颅内高压的疗效观察[J].中西医结合心脑血管病杂志,2016,14(12):1331-1334.
[9]刘显胜,秦献魁,高钰琪.高压氧治疗对急性高原病的应用与发展探析[J].中华航海医学与高气压医学杂志,2016,23(3):252-254.
[10]张源,张文进,田毅,等.大鼠创伤性颅脑损伤程度与血清MCP-1、VEGF及损伤区CD34+细胞表达水平的关系[J].中华神经医学杂志,2014,13(3):224-228.
[11]Wei X E,Li Y H,Zhao H,et al.Quantitative evaluation of hyperbaric oxygen efficacy in experimental traumatic brain injury:an MRI study[J].Neurol Sci,2014,35(2):295-302.
[12]冯康,文斌,问肃生.常压高浓度氧对创伤性颅脑损伤神经保护作用的研究进展[J].国际神经病学神经外科学杂志,2014,41(1):69-73.
[13]彭娟,周宏珍,史蕾,等.两种意识评估量表应用于神经外科患者中的信度和效度比较研究[J].中国实用护理杂志,2015,31(35):2672-2675.
[14]刘兵,马笑宇,杨晓辉,等.早期高压氧治疗对脑出血术后患者神经功能恢复的影响[J].现代中西医结合杂志,2015,24(19):2088-2090.
[15]花芸,戎天艺,陈贇,等.高压氧与神经变性疾病的相关性[J].中国实用神经疾病杂志,2017,20(21):111-113.
[16]苏美,孙德举.高压氧早期干预对缺氧缺血性脑病新生儿行为神经评分及智能发育的影响[J].中国医药科学,2016,6(6):34-36.
[17]Hung R,Carroll LJ,Cancelliere C,et al.Systematic review of the clinical course,natural history,and prognosis for pediatric mild traumatic brain injury:results of the International Collaboration on Mild Traumatic Brain Injury Prognosis[J].Archives of Physical Medicine&Rehabilitation,2014,95(3):S174-S191.
[18]王鹏先.高压氧早期综合治疗对重度颅脑外伤疗效的影响分析[J].世界最新医学信息文摘,2016,16(42):49.
[19]张月荣,郑海林,杨玉玲,等.高压氧治疗大脑中动脉梗塞侧肢循环的影响作用[J].中国医学装备,2014,14(s2):20.
[20]吴琼,翁其彪,梁凤娟.早期高压氧治疗对急性脑梗死患者脑血流灌注状态的影响及预后的临床研究[J].现代诊断与治疗,2015,20(11):2588-2589.