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Draft: 2001lOlO, Revised :200112-20) of hyperbaric oxygen on early severe head injury observation Lei Guang-Hui Min Jing Key words often severe brain injury in children in high-pressure oxygen 【Key Words】 'R748 【Document code Article ID】【A】 tO03-515X (2002) 06-0700 Ol a hospital in March 1992 ~ April 2000 with hyperbaric oxygen therapy for early severe head injury in children 110 cases, are controlled study of its clinical efficacy , reported as follows. Materials and Methods I. General Information severe 4, JL 205 cases of head injury patients were hospitalized in our hospital. Diagnosis of acute brain injury classification criteria,[link widoczny dla zalogowanych], and were confirmed by brain CT or MR1. Randomly divided into two groups: 1. Treatment group, 110 patients, male 8l, female 29 cases. Age 3 ~ l4 years old, with an average of 9.4 years. 46 cases of cerebral contusion in which, 18 cases of epidural hematoma, subdural hematoma (26 cases and 24 cases of cerebral contusion), intracerebral hematoma in 5 cases, l5 cases of primary brain stem injury. 46 patients undergoing craniotomy. Duration of coma longer than 24h, 34 cases of paralysis, 86 cases of limb convulsion, intracranial pressure (supine lumbar puncture pressure> 1.1kPa) 95 cases. 2. Control group, 95 patients,[link widoczny dla zalogowanych], male 74,[link widoczny dla zalogowanych], female 2l cases. Age 2 ~ l4 years, mean 9.1 years. Of which 48 cases brain contusion (22 cases, and subdural hematoma), intracerebral hematoma in 1 case, subdural hematoma, 11 cases of primary brain stem injury in l3 cases. 3l craniotomy patients. Coma of more than 24h. 2l cases of paralysis, limb convulsions 6l patients, intracranial pressure (supine lumbar puncture pressure> 1.1kPa) 82 cases. Two groups of age, sex, condition by no significant difference statistically. Second, treatment 1. Hospital or the control group of people with nerve cells after surgery nutrition, dehydration, hormones and so on. 2. In addition to conventional drug therapy group, at one hospital or 24h 24 ~ 28h after surgery with domestic large air pressure tank, after the suction chamber pressure 2.5MPa oxygen 30min, rest 10min, and then oxygen 30rain, the conventional decompression compartment as the first treatment, lO times as one course of treatment. Control of the disease in children with status epilepticus after hyperbaric oxygen therapy. Clinical evaluation of the results of a half months after the surgery, that a course of hyperbaric oxygen therapy after. Two groups results in Table 1. Can be seen from the two groups to improve the rate of consciousness, paralysis recovery rate, remission rate of seizures, intracranial pressure and mortality compared to normal rates are significant differences in the treatment group than the control group. Author: 453,100 Hui,[link widoczny dla zalogowanych], Neurosurgery, Affiliated Hospital of Xinxiang Medical College A (Hui Lei, Guang-); Luoyang City of Neurosurgery, First People's Hospital (often Jingmin) Author: Hui Lei (1970 a). Male, attending physician, bachelor's degree. Table 1 Comparison [(%)] clinical efficacy compared with the control group by chi-square test P <0 H discussed a severe brain injury than the primary brain injury, the early whole brain volume can cause bleeding and vasodilatation resistance vessels in tension reduction, caused significant increase in cerebral blood volume and intracranial pressure, brain injury there are different types of local secondary injury, including ischemia, hypoxia, anaerobic metabolism, thus affecting the function of brain cells, increase brain damage. Extent of coma with brain stem reticular activating system inhibition of cerebral vasoconstriction hyperbaric oxygen can reduce the local blood supply, it can reduce cerebral edema, and because of the increase of oxygen in the blood, to maintain tissue oxygenation , hyperbaric oxygen can increase oxygen diffusion force, increased tissue oxygen utilization, thereby restoring the function of neurons in irreversible damage. Hyperbaric oxygen to carotid artery contraction, reduced blood flow, and the role of the opposite vertebral artery, so that the reticular activating system and the brain relative increase in the partial pressure of oxygen, is conducive to wake coma and neurologic recovery. Rockswold other reported hyperbaric oxygen treatment of severe traumatic brain injury can significantly reduce early mortality. I JfJx, ~ 1l0 patients with severe traumatic brain injury in children with early use of hyperbaric oxygen therapy, the results of the treatment group rate of early awakening, recovery rate of limb function, early seizure remission rate, reduce the rate of intracranial pressure was significantly higher, and early mortality was significantly lower than the control group. That hyperbaric oxygen xq; J, Children's early treatment of traumatic brain injury model has important value. Common side effects of hyperbaric oxygen therapy for the inner ear pain and temporary hearing loss, this is due to blocked eustachian tube middle ear pressure with the surrounding air pressure imbalance caused by the tympanic membrane deformation. Clear guidance on children and blow the nose pinched, and can be self-healing. In addition, special attention should maintain the airway in children. Dysentery frequent attacks have epilepsy should first control epilepsy dysentery after hyperbaric oxygen therapy (Received :2001-12-19. Revised Online: 2 {) 02-03t8)
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