高压氧康复技术治疗创伤性脑损伤对患者应激反应及认知功能的影响

摘要/Abstract

摘要： 目的观察高压氧康复技术辅助治疗创伤性脑损伤的效果、对患者应激反应及认知功能的影响。方法选取2020年8月—2022年1月菏泽市立医院收治的创伤性脑损伤患者112例作为研究对象,经抽签法分为对照组（56例）与研究组（56例）。两组患者均先接受常规治疗,研究组联合应用高压氧康复技术治疗。使用功能独立性量表（FIM）评分以评估两组患者独立生活能力,使用神经行为认知量表（NCSE）评分以评估两组患者认知功能,使用酶联免疫吸附法检测丙二醛（MDA）、超氧化物岐化酶（SOD）、谷胱甘肽过氧化物酶（GSH-PX）等指标以评估两组患者应激反应情况,统计并对比两组的临床治愈率。结果干预前,两组患者FIM评分、NCSE评分以及氧化应激反应指标水平比较,差异无统计学意义（P>0.05）。干预后,研究组患者FIM、NCSE评分显著且大于对照组（P<0.05）。干预后,两组患者SOD和GSH-PX水平提高,MDA水平降低（P<0.05）;研究组患者SOD、GSH-PX水平高于对照组,MDA水平低于对照组（P<0.05）。研究组临床治愈率高于对照组（P<0.05）。结论高压氧康复技术治疗创伤性脑损伤患者效果显著,能有效减轻患者应激反应,提高患者认知功能,值得临床应用。

关键词: 高压氧, 颅脑创伤, 氧化应激反应, 认知功能

Abstract: Objective To observe the effect of hyperbaric oxygen rehabilitation technology on traumatic brain injury and its effect on patients' stress response and cognitive function. Methods 112 patients with traumatic brain injury admitted to Heze municipal hospital from August 2020 to January 2022 were selected and divided into the comparison group (56 cases) and the study group (56 cases) by drawing lots. The two groups of patients received routine treatment first. The study group was treated with hyperbaric oxygen rehabilitation technology. Functional independence scale (FIM) was used to evaluate their independent living ability, neurobehavioral cognitive scale (NCSE) was used to evaluate their cognitive function, and malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and other indicators were detected by enzyme immunoassay to evaluate their stress response. The clinical cure rates of the two groups were statistically analyzed and compared. Results Before intervention, there was no difference between the two groups in FIM score, NCSE score and oxidative stress response (P>0.05). After intervention, the FIM and NCSE scores of the study group were significantly higher than those of the control group (P<0.05). After intervention, the level of SOD and GSH-PX of the two groups were increased and the level of MDA of the two groups were decreased (P<0.05); the level of SOD, GSH-PX and MDA of the study group were higher than those of the control group (P<0.05). The clinical cure rate of the study group was higher than the control group (P<0.05). Conclusion Hyperbaric oxygen rehabilitation is effective in the treatment of traumatic brain injury, which can effectively reduce stress response and improve cognitive function of patients.

Key words: hyperbaric oxygen, craniocerebral trauma, oxidative stress response, cognitive function

中图分类号:

R651.1

顾黎明. 高压氧康复技术治疗创伤性脑损伤对患者应激反应及认知功能的影响[J]. 中华养生保健, 2023, 41(3): 19-22.

GU Li-ming. Effect of Hyperbaric Oxygen Rehabilitation on Stress Response and Cognitive Function of Patients with Traumatic Brain Injury[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(3): 19-22.

参考文献

[1] 王碰起,魏梁锋,周苏键,等.高压氧治疗对亚急性期创伤性脑损伤患者腺垂体功能的影响[J].中华物理医学与康复杂志,2020,42(8):712-715.
[2] 汪静,汪琼.情志护理联合综合康复训练对脑损伤后患者神经功能及认知功能的影响研究[J].贵州医药,2021,45(7):1163-1165.
[3] 章奇,刘苏,孙丽,等.创伤性脑损伤患者认知功能影响因素分析[J].中华航海医学与高气压医学杂志,2020,27(4):427-430,457.
[4] 张奕. 创伤性颅脑损伤的高压氧治疗[J].中华医学信息导报,2021, 36(16):10.
[5] 中华医学会神经外科学分会,中国神经外科重症管理协作组.中国重型颅脑创伤早期康复管理专家共识(2017)[J].中华医学杂志,2017,97(21):1615-1623.
[6] 中国康复医学会高压氧康复专业委员会,解放军总医院第六医学中心.颅脑创伤高压氧治疗的专家共识[J].中华航海医学与高气压医学杂志,2021,28(3):271-275.
[7] 朱燕,王毅,王文敏.神经行为认知状态测验的信度和效度研究[J].中国临床康复,2003,7(7):1084-1086.
[8] 吴毅,EsselmanP.功能独立性评价量表作为康复治疗前后和随访的功能评价指标[J].中华物理医学与康复杂志,2001,23(6):331-333.
[9] 刘志喜,石倩萍,杨洪霞,等.匹兹堡睡眠质量指数量表在护理人群中的信效度评价[J].汕头大学医学院学报,2020,33(3):173-176.
[10] 王倩,王卫亮,裴荷珠,等.脑损伤患者症状群与急性应激障碍的相关研究[J].中华行为医学与脑科学杂志,2019,28(3):244-248.
[11] 田雨,苗树船,黄进,等.高压氧治疗ICU重症颅脑损伤恢复期患者的临床研究[J].创伤外科杂志,2020,22(7):517-520.
[12] 曹素雅,葛春燕,崔益秋,等.高压氧结合偏瘫手佩戴手功能位保持枕干预对脑损伤后偏瘫患者疗效及运动功能的影响[J].中华航海医学与高气压医学杂志,2021,28(6):728-731.
[13] 李建,于朝霞,王鑫,等.高压氧治疗创伤性脑损伤的临床疗效及对血清NGAL和泛素羧基末端水解酶L1表达的影响[J].生物医学工程与临床,2020,24(5):560-564.
[14] 董海燕,章艳,吕莉丽,等.高压氧治疗对急性脑梗死合并颈动脉粥样硬化斑块患者认知功能及血清同型半胱氨酸水平的影响[J].中华航海医学与高气压医学杂志,2020,27(1):92-94.
[15] 李亚斌,王希瑞,尚金星,等.亚低温结合高压氧治疗重型颅脑损伤的疗效分析[J].中国临床神经外科杂志,2020,25(5):293-295.
[16] 马兴才,王瀚,农大环,等.高压氧治疗重型颅脑损伤临床疗效观察[J].医学临床研究,2020,37(2):288-290.
[17] 杨静,牛瑞芳.高压氧综合护理模式对早期重型颅脑损伤患者的应用效果及并发症预防研究[J].中国全科医学,2021,24(S2):222-225.
[18] 黄小林,孔冰,付禹尧,等.布托啡诺联合右美托咪定对创伤性颅脑损伤患者镇痛效果的评价[J].医药前沿,2020,10(34):110-111.
[19] 丁政,周苏键,彭慧平,等.早期高压氧干预对创伤性脑损伤后认知功能障碍影响的DTI研究[J].中华物理医学与康复杂志,2019, 41(3):189-194.
[20] 张杰,师亚玲,黄卫东,等.高压氧治疗改善大鼠颅脑损伤后神经功能障碍的效果及机制研究[J].中华航海医学与高气压医学杂志,2021,28(2):224-228.