陈超　范永春　张俊等

[摘要] 目的 研究高压氧联合神经节苷脂治疗重度颅脑损伤的临床效果。 方法 选取2013年4月～2015年3月我院收治的82例重度颅脑外伤患者，随机分为观察组（高压氧联合神经节苷脂治疗）与对照组（常规治疗）各41例，比较两组的临床效果。 结果 观察组的治愈率为46.34%，较对照组更高；观察组的死亡率仅为4.88%，与对照组比较相对更低，组间差异具统计学意义（x2=8.39，5.08，P<0.05）；治疗后观察组的GCS评分与Barthel指数分别为（11.57±2.18）分、（67.80±6.26）分，均较对照组有明显提升，组间比较差异显著（t=9.56，14.52，P<0.05）。 结论 应用高压氧联合神经节苷脂治疗重度颅脑损伤的效果确切，有利于患者预后的改善，可促进功能恢复，降低死亡或运动功能障碍的发生风险。

[关键词] 高压氧；神经节苷脂；重度颅脑外伤；临床效果

[中图分类号] R651.15 [文献标识码] B [文章编号] 2095-0616（2015）18-132-03

[Abstract] Objective To study Hyperbaric oxygen combined with ganglioside in treatment of severe traumatic brain injury. Methods 82 patients with severe traumatic brain injury，who were in hospital from March 2015 to April 2013 were selected and randomly divided into observation group （hyperbaric oxygen combined with ganglioside） and control group （conventional treatment）， 41 cases in each group. The clinical effects of two groups were compared. Results The cure rate of observation group was 46.34%， higher than that of control group. The mortality rate of the observation group was 4.88%， relatively lower compared with control group， with a statistically significant difference between the groups （x2=8.39， 5.08， P<0.05）. After treatment， the GCS score and Barthel index of the observation group were （11.57±2.18） and （67.80±6.26）， were significantly improved compared with the control group. The differences were significant （t=9.56， 14.52， P<0.05）. Conclusion The effect of hyperbaric oxygen combined with ganglioside in treatment of severe traumatic brain injury is exact， it is beneficial to improve the prognosis of patients， and can promote functional recovery， reduce the risk of death or motor dysfunction.

[Key words] Hyperbaric oxygen； Gangliosides； Severe traumatic brain injury； Clinical effect

调研结果显示，在工业化国家，重度颅脑损伤已成为导致青壮年人群死亡、残疾的首要原因[1]。虽说在近年来我国对于重度颅脑损伤的治疗已取得了不错进展，整体死亡率下降明显[2]。但存活者的预后普遍不佳。为了进一步研究重度颅脑损伤的有效方法，本研究通过随机对照试验，分析高压氧与神经节苷脂联合疗法的临床应用效果，旨在为临床工作提供参考。具体内容整理后汇报如下。

1 资料与方法

1.1 一般资料

纳入2013年4月～2015年3月我院接诊的82例重度颅脑外伤患者，作为本次的研究对象。所有入选对象均经颅脑CT或MRI等影像学检查后确诊[3-4]，无误诊病例。按照完全随机数表方法，将入选对象分为观察组与对照组各41例，观察组中男23例，女18例，患者年龄25～69岁，平均（42.2±5.4）岁，损伤类型：硬膜外血肿15例，脑内血肿11例，脑挫裂伤9例，蛛网膜下腔出血6例；对照组中男22例，女19例，患者年龄26～70岁，平均（43.2±5.1）岁，损伤类型：硬膜外血肿13例，脑内血肿12例，脑挫裂伤10例，蛛网膜下腔出血6例。……