本文選題：高壓氧療法 + 創(chuàng)傷性顱腦損傷　； 參考：《南昌大學(xué)》2015年碩士論文

【摘要】：目的:探討創(chuàng)傷性顱腦損傷患者高壓氧介入的最佳時(shí)間。方法:選取2013年4月至2014年12月在中國(guó)人民解放軍第94醫(yī)院入院后經(jīng)康復(fù)科常規(guī)藥物治療或常規(guī)藥物治療聯(lián)合高壓氧療法治療后的顱腦損傷患者269例進(jìn)行回顧性分析,其中輕型顱腦損傷患者112例、中型顱腦損傷患者88例、重型顱腦損傷患者69例。根據(jù)其是否進(jìn)行高壓氧治療分成2組,高壓氧治療組和非高壓氧治療組(常規(guī)療法,不介入高壓氧療法)。根據(jù)其傷后介入高壓氧療法時(shí)間分為4組:A組(傷后15天內(nèi))、B組(傷后16~30天)、C組(傷后31天及其31天以上),D組(非高壓氧治療)。治療組進(jìn)行3個(gè)療程高壓氧治療,非治療組不進(jìn)行高壓氧治療�；颊咧委熐斑M(jìn)行GCS評(píng)分,治療后進(jìn)行GOS評(píng)分。分別就各組進(jìn)行高壓氧治療后的治療效果進(jìn)行比較。結(jié)果:(1)比較高壓氧治療組與非高壓氧治療組,治療后比較兩組GOS評(píng)分及有效率,其差異有統(tǒng)計(jì)學(xué)差異(P0.05)。(2)A組患者治療前GCS評(píng)分為9.72±3.56,B組患者治療前GCS評(píng)分9.85±3.24,C組患者治療前GCS評(píng)分9.78±3.72,D組患者治療前GCS評(píng)分9.52±3.44。A組患者治療后GCS評(píng)分為13.94±1.01,B組患者治療后GCS評(píng)分12.61±1.09,C組患者治療后GCS評(píng)分11.78±1.21,D組患者治療后GCS評(píng)分10.73±1.08。(3)A組患者治療后依照GOS系統(tǒng)評(píng)分:1分患者0人,2分患者1人,3分患者1人,4分患者17人,5分患者49人;B組患者治療后依照GOS系統(tǒng)評(píng)分:1分患者0人,2分患者1人,3分患者9人,4分患者21人,5分患者41人;C組患者治療后依照GOS系統(tǒng)評(píng)分:1分患者0人,2分患者4人,3分患者14人,4分患者10人,5分患者37人;D組患者治療后依照GOS系統(tǒng)評(píng)分:1分患者0人,2分患者10人,3分患者19人,4分患者7人,5分患者28人。(4)單因素分析結(jié)果表明:職業(yè)、文化程度、致傷原因等差異對(duì)高壓氧療法治療顱腦損傷沒有統(tǒng)計(jì)學(xué)意義(P0.05)。年齡、病情差異對(duì)高壓氧療法治療顱腦損傷有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:(1)單因素分析結(jié)果表明:性別、職業(yè)、收入、文化程度,受傷方式對(duì)高壓氧療法介入創(chuàng)傷性顱腦損傷治療的療效沒有影響。(2)顱腦損傷患者介入高壓氧治療時(shí)且患者損傷程度相等時(shí),高壓氧療法介入治療顱腦損傷患者越早,療效愈佳。(3)顱腦損傷患者介入高壓氧治療,高齡患者預(yù)后較差。(4)中、重度顱腦損傷患者介入高壓氧治療,其預(yù)后效果較之常規(guī)治療組有提高(P0.05),輕度顱腦損傷患者介入高壓氧治療,其預(yù)后效果較之常規(guī)治療組沒有差異(P0.05)
[Abstract]:Objective: To explore the best time for hyperbaric oxygen intervention in patients with traumatic brain injury. Methods: a retrospective analysis was made in 269 cases of craniocerebral injury after the admission from April 2013 to December 2014 in the ninety-fourth Hospital of the people's Liberation Army, which were treated with conventional medicine or conventional medication combined with hyperbaric oxygen therapy. 112 cases of brain injury, 88 cases of medium craniocerebral injury and 69 cases of severe craniocerebral injury were divided into 2 groups according to whether they were treated with hyperbaric oxygen therapy, the hyperbaric oxygen therapy group and the non hyperbaric oxygen therapy group (routine therapy, no hyperbaric oxygen therapy) were divided into 4 groups according to the intervention time of the interventional hyperbaric oxygen therapy after the injury: A group (15 days after injury), group B (16~ after injury) 30 days), group C (31 days after injury and more than 31 days), group D (non hyperbaric oxygen therapy). The treatment group was treated with 3 courses of hyperbaric oxygen, and the non treatment group did not carry out hyperbaric oxygen therapy. The patients were treated with GCS score before treatment, and after the treatment, the GOS scores were compared. Results: (1) compared with hyperbaric oxygen therapy (1) Group and non hyperbaric oxygen therapy group, after treatment compared two groups of GOS score and effective rate, the difference was statistically significant (P0.05). (2) group A patients before the treatment of GCS score was 9.72 + 3.56, B group before treatment GCS score 9.85 3.24, C group before treatment GCS score 9.78 + 3.72, D group patients before the treatment of GCS score 9.52 + 3.44.A group after treatment GCS scores after treatment The GCS score of group B was 12.61 + 1.09 after treatment in group B, and GCS score of group C was 11.78 + 1.21 after treatment. The GCS score in group D was 10.73 + 1.08. (3) A group after treatment. After treatment, the patients were 0, 2, 1 and 3 patients. The B group was graded according to GOS system. There were 0 patients, 1 in 2, 9 in 3, 21 in 4 and 41 in 5. After treatment, the patients in group C were divided into 1 patients, 0, 2, 3, and D patients were graded according to GOS system. 28 patients. (4) the results of single factor analysis showed that there was no statistical significance in the treatment of craniocerebral injury with hyperbaric oxygen therapy (P0.05). The difference in age and disease was significant (P0.05) in the treatment of craniocerebral injury (P0.05). (1) the results of single factor analysis showed that sex, occupation, income, cultural history Degree, the way of injury has no effect on the therapeutic effect of hyperbaric oxygen therapy on traumatic brain injury. (2) when patients with craniocerebral injury intervene hyperbaric oxygen therapy and the degree of injury is equal, the more early the patients with craniocerebral injury are treated with hyperbaric oxygen therapy, the better the curative effect. (3) the patients with craniocerebral injury intervened hyperbaric oxygen therapy, and the prognosis of the elderly patients is poor. 4) in the patients with severe craniocerebral injury, the prognosis of hyperbaric oxygen therapy was higher than that of the conventional treatment group (P0.05), and the patients with mild craniocerebral injury intervened hyperbaric oxygen therapy, and the prognosis was no difference compared with those in the conventional treatment group (P0.05).

【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R651.15

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