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目的探讨高压氧治疗脑膜瘤术后脑水肿的疗效及对神经功能的影响。方法将2012年8月—2015年8月本院收治的66例脑膜瘤术后脑水肿患者随机分为观察组和对照组各33例。对照组患者行常规治疗,观察组患者在常规治疗的基础上行高压氧治疗。于2组患者治疗前后,测量脑水肿体积,评价神经功能缺损评分(neurologic impairment score,NIS),检测血清人S100B蛋白及神经元特异性烯醇化酶(neuronspecific enolase,NSE)指标值。计量资料两组间比较采用独立样本t检验,组内比较采用配对t检验,不同治疗时间比较采用重复测量资料的方差分析,两两比较采用LSD法;计数资料比较采用χ2检验,P<0.05为差异有统计学意义。结果不同治疗时间脑水肿体积变化情况比较,差异有统计学意义(F=14.283,P<0.05);2组患者脑水肿体积变化情况比较,差异有统计学意义(F=8.758,P<0.05)。两两比较发现,与治疗前比较,治疗3、7、14 d脑水肿体积逐渐缩小,差异均有统计学意义(均P<0.05)。治疗后,观察组患者患者的NIS评分、血清人S100B蛋白、NSE指标水平[(14.17±5.07)分、(0.85±0.13)、(10.77±2.13)ng/L]均低于对照组[(19.52±6.25)分、(1.12±0.18)、(15.26±3.31)ng/L],差异均有统计学意义(均P<0.05)。治疗前后2组患者NIS评分、血清人S100B蛋白、NSE指标水平比较,差异均有统计学意义(均P<0.05)。结论在常规治疗的基础上辅助应用高压氧治疗能有效提高脑膜瘤术后脑水肿的临床疗效,提高患者神经功能的康复效果,改善患者预后。
Objective To investigate the effect of hyperbaric oxygen on postoperative brain edema and its effect on neurological function. Methods Sixty-six patients with brain edema after operation in our hospital from August 2012 to August 2015 were randomly divided into observation group (33 cases) and control group (33 cases). Patients in the control group underwent routine therapy. Patients in the observation group underwent hyperbaric oxygen therapy on the basis of routine treatment. The volume of brain edema, the neurologic impairment score (NIS), the serum S100B protein and the neuron-specific enolase (NSE) were measured before and after treatment. Measurement data were compared between two groups using independent samples t test, the group was compared with paired t test, the comparison of different treatment time using repeated measures of variance analysis, LSD comparison method; count data were compared using the χ2 test, P <0.05 The difference was statistically significant. Results The changes of cerebral edema volume at different treatment time were statistically significant (F = 14.283, P <0.05). The volume changes of cerebral edema in two groups were statistically different (F = 8.758, P <0.05) . The comparison between two groups showed that the volume of cerebral edema on 3, 7 and 14 d after treatment decreased gradually, with statistical significance (all P <0.05). After treatment, the NIS score, serum S100B protein and NSE index in the observation group were significantly lower than those in the control group [(14.17 ± 5.07), (0.85 ± 0.13) and (10.77 ± 2.13) ng / L, respectively] ± 6.25) points, (1.12 ± 0.18) and (15.26 ± 3.31) ng / L, respectively, with significant difference (all P <0.05). Before and after treatment, NIS score, serum S100B protein and NSE index of two groups were significantly different (all P <0.05). Conclusion On the basis of routine treatment, the adjunct hyperbaric oxygen therapy can effectively improve the clinical curative effect of cerebral edema in patients with meningioma, improve the rehabilitation effect of neurological function, and improve the prognosis of patients.