[1]李亚斌　王希瑞　尚金星　赵志煌　李　刚　张宝旭.亚低温结合高压氧治疗重型颅脑损伤的疗效分析[J].中国临床神经外科杂志,2020,(05):293-295.[doi:10.13798/j.issn.1009-153X.2020.05.012]
　LI Ya-bin,WANG Xi-rui,SHANG Jin-xing,et al.Analysis of therapeutic effect of mild hypothermia combined with hyperbaric oxygen on severe traumatic brain injury[J].,2020,(05):293-295.[doi:10.13798/j.issn.1009-153X.2020.05.012]
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亚低温结合高压氧治疗重型颅脑损伤的疗效分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2020年05期
页码:
293-295
栏目:
论著
出版日期:
2020-05-25

文章信息/Info

Title:
Analysis of therapeutic effect of mild hypothermia combined with hyperbaric oxygen on severe traumatic brain injury
文章编号:
1009-153X（2020）05-0293-03
作者:
李亚斌　王希瑞　尚金星　赵志煌　李　刚　张宝旭
061000 河北，沧州市中心医院神经外三科（李亚斌、王希瑞、尚金星、赵志煌、李　刚、张宝旭）
Author(s):
LI Ya-bin;  WANG Xi-rui;  SHANG Jin-xing;  ZHAO Zhi-huang;  LI Gang;  ZHANG Bao-xu.
Department of Neurosurgery, Cangzhou Central Hospital, Cangzhou 061000, China
关键词:
重型颅脑损伤; 去骨瓣减压术; 高压氧治疗; 亚低温治疗; 应激反应; 和肽素; 髓鞘碱性蛋白
Keywords:
Severe traumatic brain injury;  Hyperbaric oxygen;  Mild hypothermia therapy;  oxidative stress;  Serum;  myelin basic
分类号:
R 651.1+5
DOI:
10.13798/j.issn.1009-153X.2020.05.012
文献标志码:
A
摘要:
目的 探讨亚低温联合高压氧治疗重型颅脑损伤（sTBI）的效果及机制。方法 2017年8月至2018年4月前瞻性收集符合标准的sTBI共66例，均采用去骨瓣减压术治疗，术后采用亚低温治疗33例（对照组），采用高压氧联合亚低温治疗33例（观察组）。治疗前、治疗后8周，采用GCS评分、GOS评分、日常生活活动能力量表（ADL）评分、Epworth嗜睡量表（ESS）评分评估疗效；检测血清髓鞘碱性蛋白（MBP）、和肽素以及氧化应激指标[肾素、肾上腺素、血管紧张素Ⅱ（AngⅡ）以及去甲肾上腺素（NE）]水平。结果 治疗后8周，两组GCS评分、GOS评分、ADL评分、ESS评分均显著升高（P<0.05），而且观察组均显著高于对照组（P<0.05）。治疗后8周，两组血清MBP、和肽素水平均显著下降（P<0.05），而且观察组均显著低于对照组（P<0.05）。治疗后8周，两组血清肾素、肾上腺素、AngⅡ、NE水平均明显升高，但是观察组均明显低于对照组（P<0.05）。结论 sTBI去骨瓣减压术后，亚低温和高压氧均是有效治疗方法，而且两者联合效果更好，其机制可能与降低MBP、和肽素水平，以及抑制应激反应有关
Abstract:
Objective To explore the effect of mild hypothermia (MH) combined with hyperbaric oxygen therapy (HOT) on severe traumatic brain injury (sTBI) and their mechanisms. Methods Sixty-six patients with sTBI were prospectively collected from August 2017 to April 2018. All the patients were treated with standard decompressive craniectomy. After the operation, 33 patients were treated with MH (control group), and 33 with HOT combined with MH (observation group). Before the operation and 8 weeks after the operation, GCS score, GOS score, ADL score and Epworth sleepiness scale (ESS) score were used to evaluate the clinical efficacy; serum myelin basic protein (MBP), copeptin and oxidative stress indicators including renin, epinephrine, angiotensin Ⅱ (Ang II) and norepinephrine (NE) was detected. Results The GCS score, GOS score, ADL score, and ESS score were significantly increased 8 weeks after the operation than before the operation in both groups (P<0.05), and these scores were significantly higher in observation group than control group 8 weeks after the operation (P<0.05). The serum levels of MBP and copeptin were decreased significantly 8 weeks after the operation than before the operation in both groups (P<0.05), and the serum levels of MBP and copeptin in observation group were significantly lower than control group 8 weeks after the operation (P<0.05). The levels of serum renin, epinephrine, AngⅡ, and NE were significantly increased 8 weeks after the operation than before the operation in both groups (P<0.05), but the serum levels of these oxidative stress indicators were significantly lower in observation group than control group 8 weeks after the operation (P<0.05). Conclusions For the patients with sTBI after decompression, MH and HOT are effective adjuvant treatments, and the effect of the combination of two methods is better than pure MH. The mechanism of MH and HOT may be related to the reduction of serum levels of MBP and copeptin and the suppression of stress response

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备注/Memo

备注/Memo:
（2019-07-01收稿，2020-03-25修回）
更新日期/Last Update: 1900-01-01