不同治疗频率及时机高压氧治疗颅脑外伤的疗效观察
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摘要
目的:研究不同治疗频率及时机的高压氧治疗对颅脑外伤的治疗效果的影响。
方法:选取颅脑外伤患者轻型104例、中型93例及重型79例(共276例患者),将其随机分为2组,A组132例:1天2次高压氧组;B组144例:1天1次高压氧组,各组在药物治疗的同时按治疗时间的7天以内、7-30天以内和30天以后分为三组,两组之间分别对治疗后不同伤情、治疗时机及年龄治疗的效果进行比较。
结果:高压氧治疗A、B两组GCS评分组间比较:治疗前GCS评分无统计学意义(P＞0.05);治疗后两组GCS评分比较差异有统计学意义(P＜0.05),组内比较:两组治疗前后GCS评分比较差异有统计学意义(P＜0.05)。两组伤后3个月GOS分级比较差异有统计学意义(P＜0.05)。不同年龄组组间比较和不同时机组间比较差异均有统计学意义(P＜0.05),按不同伤情、治疗时机及年龄综合比较:轻度脑外伤病人不同时机、不同年龄的A、B两组组间比较差异有统计学意义(P＞0.05);中度脑外伤病人不同时机、不同年龄的A、B两组组间比较差异均有统计学意义(P＜0.05);重度脑外伤病人除51-78岁组、不及时组其他各组的A、B间比较差异均有统计学意义(P＜0.05)。
结论:①根据本研究提示按本院高压氧科的高压氧处方剂量和操舱方法对于脑外伤病人的早期高压氧治疗以每天2次优于每天1次。②按治疗时机和病人年龄分组比较,提示脑外伤后早期治疗优于延期治疗,年龄大者预后较差。③本观察中只有中度脑外伤病人不同时机和各年龄段的A、B组间均有显著性差异,提示轻度患者可能出现假阳性,重度患者可能出现假阴性结果。
Objective: To study the effect of hyperbaric oxygen treatment for brain trauma.
Method: Selected sample 104 patients with light brain trauma, 95 with moderate brain trauma and 77 with severe brain trauma(276 patients). Each team was randomly assigned to 2 group:Group A(giving hyper baric oxygen treatment twice a day) and Group B (giving hyperbaric oxygen treatment once a day).At the same time all patients were given drug treatment and allocated into three groups according to the beginning time of their treatment. Then analysed the effect with different dosage and time on brain trauma.
Result: Compare the scores of GCS between Group A and B:there is no significant difference before the treatment (P>0.05), after the treatment there is different in a statistically significant way between two groups(P<0.05) and between before and after the treatment(P<0.05). In three months after the injury, classification of GOS between two groups is significant difference(P<0.05). There is significant difference in different groups of ages and time , analysing the therapeutic effect by HBO in different groups classified by injury grades, beginning times of the treatment and ages:there is no significant difference in patients with light brain trauma(P>0.05);In patients with moderate and severe brain trauma, there is respectively different in a statistically significant way between different groups classified by the ways of the treatment given,beginning times of the treatment and ages(P<0.05).
Conclusion:①For patients with moderate and severe brain injury, the effect of early HBO treatment twice a day is better than once a day;② According to the beginning time of their treatment and ages , it indicates that the earlier the patient is treated by hyper baric oxygen, the better the effect will be and that the prognosis for elder patients is worse.③In this observation it results that there is significant difference in different groups of patients with only moderate brain trauma classified by different beginning times of the treatment and ages, and it shows that patients with moderate brain trauma is the best selection of objectives for the effect analysis by HBO now that false positive may emergy in patients with light brain trauma and false negative may emergy in those with severe brain trauma.
方法:选取颅脑外伤患者轻型104例、中型93例及重型79例(共276例患者),将其随机分为2组,A组132例:1天2次高压氧组;B组144例:1天1次高压氧组,各组在药物治疗的同时按治疗时间的7天以内、7-30天以内和30天以后分为三组,两组之间分别对治疗后不同伤情、治疗时机及年龄治疗的效果进行比较。
结果:高压氧治疗A、B两组GCS评分组间比较:治疗前GCS评分无统计学意义(P＞0.05);治疗后两组GCS评分比较差异有统计学意义(P＜0.05),组内比较:两组治疗前后GCS评分比较差异有统计学意义(P＜0.05)。两组伤后3个月GOS分级比较差异有统计学意义(P＜0.05)。不同年龄组组间比较和不同时机组间比较差异均有统计学意义(P＜0.05),按不同伤情、治疗时机及年龄综合比较:轻度脑外伤病人不同时机、不同年龄的A、B两组组间比较差异有统计学意义(P＞0.05);中度脑外伤病人不同时机、不同年龄的A、B两组组间比较差异均有统计学意义(P＜0.05);重度脑外伤病人除51-78岁组、不及时组其他各组的A、B间比较差异均有统计学意义(P＜0.05)。
结论:①根据本研究提示按本院高压氧科的高压氧处方剂量和操舱方法对于脑外伤病人的早期高压氧治疗以每天2次优于每天1次。②按治疗时机和病人年龄分组比较,提示脑外伤后早期治疗优于延期治疗,年龄大者预后较差。③本观察中只有中度脑外伤病人不同时机和各年龄段的A、B组间均有显著性差异,提示轻度患者可能出现假阳性,重度患者可能出现假阴性结果。
Objective: To study the effect of hyperbaric oxygen treatment for brain trauma.
Method: Selected sample 104 patients with light brain trauma, 95 with moderate brain trauma and 77 with severe brain trauma(276 patients). Each team was randomly assigned to 2 group:Group A(giving hyper baric oxygen treatment twice a day) and Group B (giving hyperbaric oxygen treatment once a day).At the same time all patients were given drug treatment and allocated into three groups according to the beginning time of their treatment. Then analysed the effect with different dosage and time on brain trauma.
Result: Compare the scores of GCS between Group A and B:there is no significant difference before the treatment (P>0.05), after the treatment there is different in a statistically significant way between two groups(P<0.05) and between before and after the treatment(P<0.05). In three months after the injury, classification of GOS between two groups is significant difference(P<0.05). There is significant difference in different groups of ages and time , analysing the therapeutic effect by HBO in different groups classified by injury grades, beginning times of the treatment and ages:there is no significant difference in patients with light brain trauma(P>0.05);In patients with moderate and severe brain trauma, there is respectively different in a statistically significant way between different groups classified by the ways of the treatment given,beginning times of the treatment and ages(P<0.05).
Conclusion:①For patients with moderate and severe brain injury, the effect of early HBO treatment twice a day is better than once a day;② According to the beginning time of their treatment and ages , it indicates that the earlier the patient is treated by hyper baric oxygen, the better the effect will be and that the prognosis for elder patients is worse.③In this observation it results that there is significant difference in different groups of patients with only moderate brain trauma classified by different beginning times of the treatment and ages, and it shows that patients with moderate brain trauma is the best selection of objectives for the effect analysis by HBO now that false positive may emergy in patients with light brain trauma and false negative may emergy in those with severe brain trauma.
引文
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