摘要
目的神经节苷脂联合高压氧均为重型颅脑损伤治疗方法,两者联合效果尚不明确,本研究探讨神经节苷脂联合高压氧对重型颅脑损伤患者脑复苏成功率及神经功能影响。方法选取2013-01-01-2019-06-30固始县人民医院收治的重型颅脑损伤患者100例,根据性别、年龄和格拉斯哥昏迷评分(Glasgow coma scale,GCS)组间保持均衡的原则分为两组,各50例。对照组给予高压氧治疗,观察组给予神经节苷脂联合高压氧治疗,对比分析两组患者脑复苏成功率、神经损伤、神经营养及神经功能。结果治疗后,观察组清醒率为92.00%,高于对照组的76.00%,χ2=4.762,P=0.029。治疗后,观察组星形胶质源性蛋白(astrocyte-derived protein,S100β)水平为(0.14±0.03)ng/mL,低于对照组的(0.28±0.02)ng/mL,t=27.456,P<0.001;胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)水平为(1.57±0.16)pg/mL,低于对照组的(2.58±0.28)pg/mL,t=22.146,P<0.001;泛素羧基末端水解酶L1(ubiquitin carboxyterminal hydrolase L1,UCH-L1)水平为(0.50±0.22)pg/mL,低于对照组的(1.14±0.17)pg/mL,t=16.278,P<0.001;神经元特异性烯醇化酶(2phosphod glycerate hydrolase,NSE)水平为(13.02±3.42)pg/mL,低于对照组的(19.98±2.46)pg/mL,t=11.682,P<0.001。治疗后,观察组神经生长因子(nerve growth factor,NGF)水平为(19.46±1.94)pg/mL,高于对照组的(11.42±1.53)pg/mL,t=23.010,P<0.001;脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)水平为(23.53±1.52)pg/mL,高于对照组的(15.26±1.78)pg/mL,t=24.983,P<0.001。治疗后,观察组美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分为(18.06±2.42)分,低于对照组的(24.35±2.63)分,t=12.445,P<0.001;中国卒中量表(Chinese Stroke Scale,CSS)评分为(15.42±2.47)分,低于对照组的(22.53±2.36)分,t=4.717,P<0.001。结论神经节苷脂联合高压氧治疗重型颅脑损伤患者可增加清醒概率,提高脑复苏成功率,降低神经损伤相关因子水平,提高神经营养相关因子水平,促进其神经功能恢复。
OBJECTIVE Ganglioside combined with hyperbaric oxygen are both treatments for severe craniocerebral injury.The combined effect of the two is not clear.This study investigated the effect of ganglioside combined with hyperbaric oxygen on the success rate of cerebral resuscitation and neurological function in patients with severe craniocerebral injury.METHODS A total of 100 patients with severe traumatic brain injury treated in our hospital from January 01,2013 to June 30,2019 were selected and divided into two groups according to the principle of maintaining gender,age,and GCS scores,with 50 patients in each group.The control group was treated with hyperbaric oxygen,and the observation group was treated with ganglioside combined with hyperbaric oxygen.The two groups were compared and analyzed for the success rate of brain resuscitation,nerve injury,neurotrophy and nerve function.RESULTS After treatment,the awake rate in the observation group was 92.00%,which was higher than the 76.00%in the control group,χ2=4.762,P=0.029.After treatment,the level of astrocyte-derived protein(S100β)in the observation group was(0.14±0.03)ng/ml,which was lower than the control group(0.28±0.02)ng/ml,t=27.456,P<0.001.The level of glial fibrillary acidic protein(GFAP)was(1.57±0.16)pg/ml,which was lower than that of the control group(2.58±0.28)pg/ml,t=22.146,P<0.001.The ubiquitin carboxy-terminal hydrolase L1(UCH-L1)level was(0.50±0.22)pg/ml,which was lower than that of the control group(1.14±0.17)pg/ml,t=16.278,P<0.001.Neuron-specific enolase(phosphod glycerate hydrolase,NSE)level was(13.02±3.42)pg/ml,which was lower than the control group(19.98±2.46)pg/ml,t=11.682,P<0.001.After treatment,the nerve growth factor(NGF)level in the observation group was(19.46±1.94)pg/ml,which was higher than the control group(11.42±1.53)pg/ml,t=23.010,P<0.001.The level of brainderived neurotrophic factor(BDNF)was(23.53±1.52)pg/ml,which was higher than that of the control group(15.26±1.78)pg/ml,t=24.983,P<0.001.After treatment,the National Institutes of Health Stroke Scale(NIHSS)score in the observation group was(18.06±2.42)points,which was lower than the(24.35±2.63)points in the control group,t=12.445,P<0.001.The Chinese Stroke Scale(CSS)score was(15.42±2.47)points,which was lower than that of the control group(22.53±2.36)points,t=4.717,P<0.001.CONCLUSION Ganglioside combined with hyperbaric oxygen treatment can increase the chance of awake,increase the success rate of cerebral resuscitation,reduce the level of nerve injury-related factors,increase the level of neurotrophic related factors,and promote the recovery of neural function.
作者
刘丽
刘加春
汪伟
LIU Li;LIU Jia-chun;WANG Wei(Department of Intensive Care Unit,Gushi County People's Hospital,Gushi 465200,P.R.China)
出处
《社区医学杂志》
2020年第7期501-504,共4页
Journal Of Community Medicine
关键词
重型颅脑损伤
神经节苷脂
高压氧
脑复苏
神经功能
severe craniocerebral injury
ganglioside
hyperbaric oxygen
brain resuscitation
neurological function
