摘要
目的分析高压氧早期干预对胶质瘤术后患者脑水肿及炎症反应的影响。方法选取行胶质瘤手术术中诊断明确的患者21例,依据患者自身的适应医嘱情况,将21例患者分为高压氧组9例、对照组12例。对照组采用常规手术方式,术后给予止血、脱水、抗生素等常规对症处理;高压氧组在对照组治疗基础上术后第3~5天予高压氧治疗,每天予高压氧治疗1 h。比较两组患者脑水肿体积,手术后第7天,采集外周静脉血测T细胞亚群及炎性反应因子(CRP、IL-6以及TNF-α),分析其水平变化。结果术后第7天,高压氧组脑水肿体积较对照组少[(26.8±2.3)cm^3 vs.(32.5±2.9)cm^3],差异有统计学意义(P<0.05);治疗后高压氧组血浆CD4^+、CD8^+细胞百分率及CD4^+/CD8^+比值与对照组比较,差异均有统计学意义(P<0.05);治疗后高压氧组血浆CRP、IL-6以及TNF-α水平较对照组明显降低,差异均有统计学意义(P<0.05)。结论高压氧早期干预可降低胶质瘤术后患者颅内水肿,提高术后机体细胞免疫功能,降低术后创面炎性反应,提示术后尽早行高压氧治疗提高胶质瘤的治疗效果。
Objective To analyse the hyperbaric oxygen early intervention for postoperative patients with glioma brain edema and inflammatoryresponse. Methods 21 patients with clear diagnosis of glioma surgery were selected. According to the patient＇s own medical advice, 21 patients were divided into hyperbaric oxygen group （9 cases） and control group （12 cases）. The normal operation was used in the control group, and the routine treatment of hemostasis, dehydration and antibiotics was given after the operation. Hyperbaric oxygen therapy was given to hyperbaric oxygen group 3 to 5 days after treatment, and treated with hyperbaric oxygen 1 h every day. The volume of brain edema was compared between the two groups. The T lymphocyte subsets and infammatory response factors （CRP, IL-6 and TNF- alpha） were collected from peripheral venous blood on the seventh day after operation, and the level changes were analyzed. Results 7 days after operation, the volume of brain edema in hyperbaric oxygen group was less than that of the control group [（26.8 ± 2.3） cm3 vs. （32.5 ± 2.9） cm3）. The difference was statistically significant （P 〈 0.05）. After treatment, the percentage of CD4＋ and CD8＋ cells and the ratio of CD4＋/CD8＋ in hyperbaric oxygen group were statistically signifcant compared with the control group （P 〈 0.05）. After treatment, the levels of plasma CRP, IL-6 and TNF- alpha in the hyperbaric oxygen group were significantly lower than those in the control group, and the difference was statistically signifcant （P 〈 0.05）. Conclusion Hyperbaric oxygen early intervention can reduce postoperative patients with intracranial glioma edema, improve postoperative organism cellular immunity function, reduce postoperative wound infammatory reaction, tip line as soon as possible after hyperbaric oxygen therapy can improve the effect of the treatmentof gliomas.
作者
梁平
陈华群
季宏建
LIANG Ping;CHEN Huaqun(JI Hongjian Neurosurgery Department,Yancheng Third People＇s Hospital, Yancheng Jiangsu 224001, China)
出处
《中国继续医学教育》
2017年第35期45-47,共3页
China Continuing Medical Education
关键词
高压氧
胶质瘤
炎症因子
脑水肿
hyperbaric oxygen
glioma
inflammatory factors
cerebral edema
