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[1]熊鹏举,朱皓皞,温剑峰,等.呼吸机辅助高压氧舱内吸氧对弥漫性轴索损伤治疗的影响[J].医学研究与战创伤救治(原医学研究生学报),2020,22(3):258-261.[doi:10.3969/j.issn.1672-271X.2020.03.008]
　XIONG Peng-ju,ZHU Hao-hao,WEN Jian-feng,et al.Effect of respiratory assisted oxygen absorption in hyperbaric module on the treatment of diffuse axial injury[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2020,22(3):258-261.[doi:10.3969/j.issn.1672-271X.2020.03.008]
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呼吸机辅助高压氧舱内吸氧对弥漫性轴索损伤治疗的影响()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第22卷
期数:
2020年3期
页码:
258-261
栏目:
临床研究
出版日期:
2020-05-15

文章信息/Info

Title:
Effect of respiratory assisted oxygen absorption in hyperbaric module on the treatment of diffuse axial injury
作者:
熊鹏举; 朱皓皞; 温剑峰; 腾进忠; 邓磊
作者单位：330002 南昌，解放军联勤保障部队第九○八医院神经外科（熊鹏举、温剑峰、腾进忠、邓磊）,病理科（朱皓皞）
Author(s):
XIONG Peng-ju1;  ZHU Hao-hao2; WEN Jian-feng1;  TENG Jin-zhong1; DENG Lei1
（1.Department of Neurosurgery, 2.Department of Pathology, the 908th Hospital of Chinese People’s Liberation Army Joint Logistic Support Force, Nanchang 330002,Jiangxi，China）
关键词:
弥漫性轴索损伤; 呼吸机; 高压氧舱; 高压氧
Keywords:
diffuse axonalinjury;  ventilator;  hyperbaric oxygen; hyperbaric oxygen
分类号:
R651.1+
DOI:
10.3969/j.issn.1672-271X.2020.03.008
文献标志码:
A
摘要:
目的探讨呼吸机辅助高压氧舱内超早期(伤后72 h开始)吸氧对弥漫性轴索损伤治疗效果的影响。方法回顾性分析自2014年1月至2019年1月期间解放军联勤保障部队第九○八医院神经重症监护病房（NICU）收治的60例中、重度弥漫性轴索损伤患者临床资料。按开始进行高压氧治疗的时间节点不同分为超早期组和对照组，每组30例。对照组按颅脑弥漫性轴索损伤常规给予脱水、止血、营养支持、物理康复并在2周后开始接受高压氧的治疗；超早期组在对照组治疗的基础上采取超早期呼吸机辅助高压氧舱内吸氧的治疗。观察比较2组患者的病死率、开颅去骨瓣减压手术发生率及神经功能预后（ADL）评级。结果超早期组在伤后72 h以后出现继发严重脑水肿需开颅去骨瓣减压手术的发生率较对照组明显降低（36.7% vs 13.3%，P<0.05)。超早期组治疗6个月后病死率明显低于对照组（16.7% vs 40.0%，P<0.05）。超早期组治疗6个月后日常生活能力预后（ADL）评级优良率明显高于对照组（63.3% vs 33.3%，P<0.05）。结论应用呼吸机辅助高压氧舱内超早期吸氧治疗弥漫性轴索损伤可以降低病死率并改善患者的预后。
Abstract:
ObjectiveTo investigate the effect of oxygen inhalation in a hyperbaric oxygen chamber assisted by a ventilator on the treatment of diffuse axonal injury in the ultra-early stage (72 hours after injury).MethodsSixty patients with moderate and severe diffuse axonal injury treated with hyperbaric oxygen at different time periods were divided into two groups: ultra-early group (n=30) and control group (n=30). The control group was given dehydration, hemostasis, nutritional support, physical rehabilitation and began to receive hyperbaric oxygen treatment 2 weeks later;while the ultra-early group was treated with ultra-early ventilatorassisted hyperbaric oxygen cabin oxygen inhalation on the basis of the treatment of the control group.The mortality,the incidence of craniotomy and bone flap decompression and the (ADL) rating of neurological prognosis were observed and compared between the two groups.Results72 hours later,the incidence of severe secondary brain edema was reduced by bone flap decompression: the ultra-early group(13.3%) and the control group(36.7%),there was significant difference between the two groups(P<0.05). The fatality rate was 16.7% in the ultra-early group and 40.0% in the control group. There was significant difference between the two groups(P<0.05).The (GCS) score of dynamic Glasgow coma scale and the prognosis rating after 6 months were better than those of the control group. Prognosis of ability of daily living(ADL) rating excellent and good rate: ultra-early group(63.3%) and in the control group(33.3%),with statistical significance(P<0.05).ConclusionVentilator assisted hyperbaric oxygen chamber ultra-early oxygen inhalation can reduce the mortality and improve the prognosis of patients with diffuse axonal injury.

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备注/Memo

备注/Memo:
基金项目：南京军区军队医学科技创新课题科研计划（MS071）
更新日期/Last Update: 2020-05-15