高压氧治疗脑外伤硬膜下积液92例分析(1)
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【摘要】 目的 探讨高压氧治疗脑外伤后硬膜下积液的疗效。方法 分析92例脑外伤后硬膜下积液患者高压氧治疗的临床资料,研究随着疗程增加患者症状及硬膜下积液的变化。结果 随着疗程增加,患者症状缓解或消失的比例明显升高,尤其治疗2个疗程后疗效更为明显;治疗前及治疗第1、第2、第3个疗程后积液厚度分别为6.1 mm、5.5 mm、4.0 mm和2.2 mm,第2个、第3个疗程后积液厚度进一步减小,第1、2个疗程之间以及第2、3个疗程之间积液厚度差异有统计学意义(t=2.751,P=0.007;t=3.264,P=0.001)。结论 高压氧治疗脑外伤后硬膜下积液疗效明显,尤其超过2个疗程后疗效更为可观。
【关键词】 高压氧;脑外伤;硬膜下积液
Efficacy of hyperbaric oxygen treatment in 92 cases with subdural effusion after cerebral trauma.
LUO An zhi,LONG Hong chuan,LIU Si jun,et al.Department of Neurosurgery,Meishan City People’s Hospital,Meishan 620010,China
【Abstract】 Objective To investigate the efficacy of hyperbaric oxygen treatment(HBOT) in cases with subdural effusion after cerebral trauma.Methods Collected the clinical data of 92 cases with subdural effusion after cerebral trauma who underwent HBOT,and studied the change of symptom and subdural effusion with increasing treatment.Results With the increasing treatment,remission rate and cure rate of the symptom significantly increased.Especially,the effect after two courses of treatment was more significant.The subdural effusion thickness of before treatment,paragraph 1,2 and 3 course were 6.1 mm,5.5 mm,4.0 mm and 2.2 mm respectively.There was a further reduce of subdural effusion thickness after the second and third treatment course,with a significant difference of subdural effusion thickness between the first and second course,the second and third course(t=2.751,P=0.007;t=3.264,P=0.001).Conclusion The efficacy of HBOT in subdural effusion after cerebral trauma is significant,especially after two therapy courses..
【Key words】 Hyperbaric oxygen; Cerebral trauma; Subdural effusion
脑伤后易并发硬膜下积液,对此有手术治疗与保守治疗方案,然而手术治疗创伤大、易复发,高压氧在此并发症的治疗上却显示了较大优势。我院2001年2月至2009年2月间先后以高压氧治疗脑伤后硬膜下积液92例,疗效显著,报告如下。
1 资料与方法
1.1 临床资料 本组患者共92例,男68例,女24例。年龄16~63岁,平均36.6岁。有51例为交通事故所致创伤,19例为高处坠落致伤,有11例为钝器击打致伤,8例为摔倒致伤,3例为锐器刺伤。87例伴有明显的脑挫裂伤,其中脑挫裂伤部位位于额叶15例,颞叶20例,顶叶11例,枕叶3例,额叶和颞叶22例,额叶、颞叶和顶叶15例,脑干伤1例;另有5例无明显脑挫裂伤,其中2例为颞骨骨折伴少量硬膜外出血。92例中有12例同时有胸部损伤,主要为肋骨骨折、血胸,2例患者肺挫裂伤伴有大量气胸;有3例患者同时腹部损伤,均为脾破裂并急诊行了脾切除术;2例患者同时四肢骨折切开复位内固定手术治疗,4例颈椎骨折及2例腰椎骨折均制动、保守治疗。入院时Glasgow评分5~14分,平均9.6分。开颅手术治疗34例,保守治疗58例。
1.2 治疗 入院后立即完善相关辅助检查,并给予清创术、止血、降颅压、脑保护剂、抗炎、制动、对症等治疗,适时复查并调整治疗方案。待病情平稳后3~5 d开始高压氧治疗,高压氧治疗的压力为0 ......
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