Clinical Studies In Patients With Traumatic Brain Injury With Hyperbaric Oxygen Therapy Of Cerebral Hemodynamics

Objective: To observe the effects of hyperbaric oxygen on cerebral blood flowdynamics severe traumatic brain injury patients. To explore the impact of the mechanism. Todescribe its impact on the prognosis of patients with severe traumatic brain injury.Method: Collection of150cases of patients with severe head injury in Yan’anUniversity Affiliated Hospital of Neurosurgery from December2011to August2013. Twoor three days after these patients are treated bedside transcranial Doppler (TranscranialDoppler TCD) examination. According to changes in cerebral blood flow velocity injury,cerebral blood flow velocity faster groups and cerebral blood flow slowed groups are divided.All patients are randomly divided into observation group and control group, according to thecondition given dehydration reduce intracranial pressure, nerve nutrition, improve brainmetabolism, correction of electrolyte disorders, prevention of anti-infection, gastrointestinalbleeding and other treatment. When the patients are in stable vital signs, they are treated withthree courses of high-pressure oxygen therapy. All patients are grouped by beforehyperbaric oxygen therapy,10days after hyperbaric oxygen therapy, the first30days afterhyperbaric oxygen therapy in the brain to detect bilateral action (Middle Cerebral ArteryMCA), basilar artery (Basilar Artery BA) peak systolic velocity (Peak Pelocity Vs), meanflow velocity flow velocity (Mean Velocity Vm), end-diastolic flow velocity (DiastoliVelocity Vd), pulsatility index (Puls Atility Index PI), resistance index (Resistance Index Rl).Glasgow coma scale (Glasgow Coma Scale GCS) score is to test the the first course and the second course. Three months later Glasgow Outcome Classification (Glasgow OutcomeScale GOS) score is to test the results.Result: Cerebral blood flow faster after a course of treatment, the control group’s andobservation group’s Vs, Vm, Vd, PI, RI are significantly decreased in the observation groupthan that of the control group decreased more significantly, the difference are statisticallysignificant (p <0.05). After3courses of treatment, the control group’s Vs, Vm are below thenormal reference ranges, PI and RI are still higher than the normal reference ranges, thedifference is statistically significant (p <0.05). Observation group’s Vs, Vm, PI, and RI areclose to the normal reference range, with no statistically significant with the normalreference values (P>0.05). After a course of treatment group, cerebral blood flow slowsdown, but the control group’s and observation group’s Vs, Vm, and Vd increase, PI and RIdecrease significantly. Observation group is significantly more than the control group. Thedifference is statistically significant (p <0.05). After3courses of treatment, the controlgroup Vs and Vm are below the normal reference ranges, PI and RI are still higher than thenormal reference ranges, the difference is statistically significant (p <0.05). Observationgroup Vs and Vm are close to the normal reference ranges, PI and RI are slightly higher thanthe normal reference ranges. The normal reference values are not statistically significant (P>0.05). After a course of treatment, observation group and control group basilar artery (BA)Vs, Vm, and Vd increase compared with the treatment and control group has no significantdifference is observed significant differences between groups was statistically significant (p<0.05).After3courses of treatment, observation and control groups Vs, Vm, and Vd aresignificantly higher than that before treatment, the difference is significant. Comparedobservation group with the control group, Vs, Vm, and Vd increase more significantly, thedifference is significant. After a course of treatment, the observation group and the controlgroup have improved GCS scores, a significant difference comes into existence(P <0.05).But the control group has no significant difference. After2courses of treatment, observation and control groups’ health conditions are improved, the GCS score is significantly higherthan that of control group, the difference is statistically significant (P <0.05). Three monthslater, a visit of all patients is paid to test GOS score, a good prognosis group,22cases(30.56%), the prognosis is good observation group45cases (13.89%) the difference betweengroups is statistically significant (P <0.05). In the control group died10cases (13.89%), theobservation group five cases (7.14%), the difference is statistically significant (P <0.05).Conclusion:1Hyperbaric oxygen therapy can be a good change for patients withsevere traumatic brain injury of cerebral hemodynamics. It can reduce vascular resistance,improve ischemia and hypoxia, shorten the duration of coma patients, and help patientsregain consciousness.2Hyperbaric oxygen therapy can relieve cerebral vasospasm braininjury recovery, reduce blood flow resistance, improve brain metabolism, reduce thepatient’s complications, improve clinical outcomes, and improve patients’ lives.