高压氧治疗对重型颅脑损伤患者血清 NT －proBNP的影响及与预后相关性的研究

摘要

目的：探讨高压氧（ HBO）治疗对重型颅脑损伤患者血清NT－proBNP的影响及与预后的相关性。方法100例重型颅脑损伤患者分为对照组50例和治疗组50例。对照组采用急诊开颅手术处理及常规药物治疗；治疗组在对照组治疗的基础上，加用HBO治疗。在术后第4、7、10、14、21天记录两组血清NT－proBNP浓度及格拉斯哥昏迷评分（ GCS），伤后3个月随访行格拉斯哥预后评分（ GOS）。结果 HBO治疗前两组患者血清NT－proBNP浓度比较差异无统计学意义（P＞0．05）；HBO治疗后治疗组血清NT－proBNP浓度较对照组下降更明显（P＜0．05）， GCS评分与对照组比较差异有统计学意义（P＜0．05）；伤后3个月GOS评分显示，治疗组预后较对照组明显提高（ P＜0．05）。结论 HBO可迅速降低重型颅脑损伤患者血清NT－proBNP浓度，改善患者预后，提高临床疗效。%Objective To explore effects of serum NT -proBNP levels in hyperbaric oxygen ( HBO) therapy on severe traumatic brain injury patients and correlation with prognosis .Methods One hundred severe traumatic brain injury patients were randomly divided into the control group (50 cases) and the therapy group (HBO therapy group, 50 cases).The control group received craniotomy operation and conventional drug treatment , and the therapy group was given HBO therapy in addition to the same treatment received by the control group .Serum NT-proBNP levels on day 4, 7, 10, 14 and 21 after operation were determined , and the scores of Glasgow coma scale ( GCS) were measured among the two groups.Glasgow outcome scale (GOS) was evaluated in follow -ups 3 months after injury.Results Serum NT -proBNP levels of the severe traumatic brain injury patients of both groups showed no statistical difference before treatment (P>0.05).After HBO treatment, serum NT-proBNP level was decreased significantly (P<0.05), and GCS also was increased significantly in the therapy group (P<0.05).GOS made 3 months after injury indicated that the number of patients with better prognosis in the HBO group increased obviously, when a co MParison was made with the control group (P<0.05). Conclusion HBO therapy can rapidly reduce serum NT -proBNP level in patients with severe craniocerebral injury , improve the prognosis of patients , improve the clinical efficacy .