论文部分内容阅读
BACKGROUND: Plasma inflammatory factor, such as C-reactive protein, whose content is regarded as a sensitively pathological marked protein and quantitative indexes of central nervous system injury, has been paid more and more attention in clinic. OBJECTIVE: To observe the effects and clinical significance of C-reactive protein in patients with craniocerebral injury after hyperbaric oxygenation. DESIGN: Randomized controlled study.SETTING: Departments of Neurosurgery, Laboratory and Hyperbaric Oxygen, the Second Affiliated Hospital, Medical College of Shantou University.PARTICIPANTS: A total of 60 patients with craniocerebral injury were selected from Department of Neurosurgery, the Second Affiliated Hospital, Medical College of Shantou University from October 2006 to April 2007. There were 37 males and 23 females and the mean age was 26 years. All subjects were certainly diagnosed as history of craniocerebral injury. Patients hospitalized at 24 hours after injury, Glasgow Coma Score ranged from 3 to 12 points, and all patients were certainly diagnosed with CT or MR scanning. Patients and their relatives provided confirmed consent. All the subjects were randomly divided into hyperbaric oxygenation group and control group with 30 in each group.METHODS: Patients in the control group were treated with routinely neurosurgical therapy after hospitalization; however, based the same basic treatment in the control group, patients in the hyperbaric oxygenation group received hyperbaric oxygenation by using iced-wheel four-door 2-cabin air-compression chamber (made in Yantai) from 24 hours to 10 days after operation or injury. After entering the cabin, patients who had a clear consciousness breathed the oxygen by using face mask; contrarily, patients directly breathed the oxygen. Therapeutic project: Expression was increased for about 15-20 minutes, maintained for about 70 - 80 minutes, and decreased for 20 minutes. Otherwise, pressure was maintained from 0.2 to 0.25 Mpa. Hyperbaric oxygenation took an hour for once a day and 10 times were regarded as a course. Venous blood was collected before treatment and on the next day of the first course end. Content of C-reactive protein in plasma was measured with immune turbidimetry in hyperbaric oxygenation group; in addition, content of C-reactive protein in plasma was directly measured with the same method at the corresponding time in the control group. If the content was less or equal to 8 mg/L, it was regarded as normal value. Effects of the two groups were evaluated based on Glasgow Coma Score before and after treatment. MAIN OUTCOME MEASURES: Content of plasma C-reactive protein and Glasgow Coma Score in the two groups before and after treatment.RESULTS: All 60 patients were involved in the final analysis. Protein: The two contents were obviously higher than normal value after craniocerebral injury. There was no significant difference in the two groups before treatment (P ＞ 0.05), but both contents were decreased after treatment, and there was significant difference between HBOT group and control group after treatment (t =4.756, P ＜ 0.01). In addition, there was significant difference in hyperbaric oxygen therapy group before and after treatment (t =5.236, P ＜ 0.01). Glasgow Coma Score: There was no significant difference in the two groups before treatment (P ＞ 0.05), but scores were increased in both groups after treatment (t =9.92, 2.51, P ＜ 0.01, 0.05); on the other hand, therefore, there was significant difference between the two groups after treatment (t=9.21, P ＜ 0.01).CONCLUSION: Hyperbaric oxygenation can remarkably decrease content of plasma C-reactive protein in patients with craniocerebral injury at the phase of stress.