Objective To study the clinical effect of early hyperbaric oxygen combined with standard large trauma craniotomy in the treatment of patients suffered from severe traumatic brain injury.Methods The clinical data of 70 cases with severe traumatic brain injury in Hebei People's Hospital from March 2013 to January 2016 was analyzed retrospectively.35 cases of control group received standard large trauma craniotomy treatment and 35 cases of observation group received early hyperbaric oxygen combined with standard large trauma craniotomy treatment.The recovery conditions of disease of the two groups were assessed by Glasgow coma scale (GCS) before treatment and after treatment for 4 months;the nerve function indices in serum and amino acid neurotransmitters were measured by enzyme-linked immunosorbent assay (ELISA).Results The GCS scores,serum nerve function indices [nerve growth factor (NGF),glial fibrillary acidic protein (GFAP),S-100B protein (S-100B)],and the contents of amino acid neurotransmitters [glutamic acid (Glu),γ-aminobutyric acid (GABA),aspartic acid (Asp),glycine (Gly)] of both groups after treatment were significantly improved compared with those before treatment (P ＜ 0.05),and the improvement of the indices above in the observation group was significantly higher than those of the control group,the differences between the two groups were statistically significant (P ＜ 0.05).Conclusion Early hyperbaric oxygen combined with standard large craniotomy can improve the efficacy of patients with severe traumatic brain injury,optimize the nerve function and inhibit the toxic effect of excitatory amino acids.%目的 探讨早期高压氧联合标准大骨瓣开颅术治疗重型颅脑外伤的临床效果.方法 回顾性分析2013年3月～2016年1月在河北省人民医院接受治疗的70例重型颅脑外伤患者的临床资料,包括接受单纯标准大骨瓣开颅术治疗的对照组35例和接受早期高压氧联合标准大骨瓣开颅术治疗的观察组35例.采用格拉斯哥昏迷评分(GCS)对治疗前及治疗4个月后两组患者的病情恢复情况进行评估;采用酶联免疫吸附法(ELISA)检测血清神经功能指标、氨基酸类神经递质含量.结果 两组患者治疗后GCS评分、血清神经功能指标[神经生长因子(NGF)、胶质纤维酸性蛋白(GFAP)、S-100B蛋白(S-100B)]、氨基酸类神经递质[谷氨酸(Glu)、γ-氨基丁酸(GA-BA)、天冬氨酸(Asp)、甘氨酸(Gly)]含量均较治疗前显著改善,差异有统计学意义(P＜0.05),且观察组治疗后各指标的改善幅度均显著高于对照组,差异有统计学意义(P＜0.05).结论 早期高压氧联合标准大骨瓣开颅术可提升重型颅脑外伤患者的治疗,优化神经功能,并抑制兴奋性氨基酸的毒性作用.
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