高压氧早期综合治疗对颅脑外伤病人免疫功能及预后的影响
Effect of hyperbaric oxygen on immune function and prognosis in the early comprehensive treatment of patients with craniocerebral injury
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摘要: 目的：探讨高压氧疗法（HBO）早期综合治疗对颅脑外伤病人免疫功能及预后的影响。方法：118例颅脑外伤病人分为对照组和观察组，各59例。对照组在颅脑外伤31~60 d开始HBO，观察组在颅脑外伤8~30 d开始HBO。比较2组病人的格拉斯哥昏迷（GCS）评分、日常生活能力（ADL）评分、炎性因子水平、免疫指标、格拉斯哥预后（GOS）分级以及并发症情况等指标。结果：治疗3个疗程后，观察组的GCS、ADL评分均显著高于对照组（P<0.01）。治疗后2周，观察组IL-2、6、8和TNF-α各项指标均显著低于对照组，而观察组IgA、IgG、IgM和血总淋巴细胞计数显著高于对照组（P<0.01）。观察组的格拉斯哥预后分级优于对照组（P<0.01）。观察组并发症发生率显著低于对照组（P<0.01）。结论：采用HBO早期综合疗法治疗颅脑外伤疗效显著，能够显著降低促炎因子水平，降低不良反应发生率，安全性好，改善病人免疫功能状态，临床上值得继续推广。Abstract: Objective: To explore the effects of hyperbaric oxygen(HBO) on immune function and prognosis in the early comprehensive treatment of patients with craniocerebral injury.Methods: One hundred and eighteen patients with craniocerebral injury were randomly divided into the control group(59 cases) and observation group(59 cases).The control group were treated with HBO after 31 to 60d of craniocerebral injury,and the observation group were treated with HBO after 8 to 30d of craniocerebral injury.The scores of GCS and ADL,level of inflammatory cytokine,immune indicator,GOS staging and complications between two groups were compared.Results: After three courses of treatment,the scores of GCS and ADL in observation groups were significantly higher than those in control group(P<0.01).After two weeks of treatment,the levels of IL-2,IL-6,IL-8 and TNF-α in observation group were significantly lower than those in control group(P<0.01),and the levels of IgG,IgA,IgM and TLC in observation group were significantly higher than those in control group(P<0.01).The GOS staging in observation group was significantly better than that in control group(P<0.01).The incidence rate of complication in observation group was significantly lower than that in control group(P<0.01).Conclusions: The effect of HBO in the early comprehensive treatment of patients with craniocerebral injury is significant,which can significantly reduce the level of inflammatory cytokine and incidence of complication,improve the patients' immune function,and is safe and worthy of promotion in clinic.
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