·论著·高压氧对重型颅脑损伤患者外周血白细胞和继发性脑损害的影响唐晓平张涛彭华漆建唐文国段军伟赵龙王远传冯凌罗仁国李舜苟章洋【摘要】目的探讨高压氧(HBO)对重型颅脑损伤患者白细胞(WBC)及多形核嗜中性白细胞(PMN)和继发性脑损害的影响。方法将伤后24h内入院的重型颅脑损伤患者160例,根据基本情况平衡的原则,分为HBO治疗组和常规治疗组(对照组)各80例。分别于伤后1d、7d、14d、21d测定外周血WBC和PMN;并复查头颅CT,计算脑出血量及脑水肿体积;同时进行GCS评分;统计两组患者出现脑梗死的例数;伤后6个月,对两组患者进行GOS预后评分。测定40例健康体检者外周血WBC参数作为正常对照。结果(1)伤后1d,两组患者WBC和PMN较正常对照组升高,但两组之间比较差异均无统计学意义(P>0畅05);伤后7d、14d,HBO治疗组WBC和PMN较对照组低(P<0畅05或0畅01);HBO治疗组和对照组分别于伤后14d、21d时WBC和PMN恢复正常;(2)伤后7d、14d和21dHBO治疗组的脑出血量和水肿体积明显小于对照组(P<0畅05或0畅01);(3)伤后7d、14d和21dHBO治疗组GCS评分高于对照组(P<0畅05或0畅01);HBO治疗组出现外伤性脑梗死的例数较对照组少(P<0畅05);伤后6个月,HBO治疗组GOS评分高于对照组(P<0畅05)。结论HBO治疗能够减轻重型颅脑损伤的继发性损害和改善患者预后,它的作用机制之一可能是HBO能尽快、较好地恢复外周血WBC和PMN的变化。【关键词】颅脑损伤;高压氧;白细胞;中性白细胞;继发性脑损害InfluencesofhyperbaricoxygenationonwhitebloodcellandpolymorphonuclearneutropilofseverecraniocerebralinjuredpatientandsecondarybraininjuryTANGXiao唱ping,ZHANGTao,PENGHua,QIJian,TANGWen唱guo,DUANJun唱wei,ZHAOLong,WANGYuan唱chuan,FENGLing,LUORen唱guo,LIShun,GOUZhang唱yang.TheAffiliatedHospitalofNorthSichuanMedicalCollege,Nanchong637000,ChinaCorrespondingauthor:TANGXiao唱ping,Email:txping1971@163.com【Abstract】ObjectiveToinvestigatetheeffectsofhyperbaricoxygenation(HBO)onwhitebloodcell(WBC)andpolymorphonuclearneutropil(PMN)ofseverecraniocerebraltraumapatientsandsecondarybraininjury.Methods160severecraniocerebraltraumacasesinjuredwithin24hourswereassignedtoHBOgroupandcontrolgroup(80casesineachgroup)basedontheprincipleofmaintainingabasicbalance.ThedeterminationofWBCandPMN,andCTre唱examinationwerecompletedinthe1stday,7thday,14thdayand21stdayafterinjury.Inthemeantime,thevolumesofbrainhemorrhageandcerebraledemawerecalculatedandGCSscorewasevaluated,andthenumberofbraininfarctionhappenedinthetwogroupswasrecorded.TheprognosisscoreofGOSin6thmonthafterinjurywasevaluated.Results(1)Inthe1stdayafterinjury,thechangesofWBCandPMNhavenotstatisticaldifferencesbetweenthetwogroups(P>0畅05);...