Effects Of Hyperbaric Oxygen On Spinal Cord Injury And Influencing Factors

ObjectiveTo explore the therapeutic Effect of Hyperbaric Oxygen on the patients with spinal cord injury and to determine the factors correlating with the prognosis.Follow-up visits results of patients having experienced clinical parameters concluded through case history reviews are all summarized and statistical analysis was carried out to observe the outcome of Hyperbaric Oxygen on the patients with spinal cord injury and the influential factors supplying references for clinical treatments.METHODSA retrospective study of patients with spinal cord injury who were admitted in the department of orthopaedic surgery of General Hospital of Guangzhou Military Region from Oct 2000 to Dec 2008,and acquire 120cases. According to different methods,they were equally divided into NHBO group(56 cases) and HBO group(64 cases).General information on patients were collected and sorted.They included gender, age, trauma locus, injuried causes, the time of damage to the operation, admission to damage rating, onset of time of HBO therapy after operation, frequency of HBO therapy postoperation, degree of injury and the final diagnosis. The content of all follow-up cases by telephone and by mail and out-patient clinic(OPD) involved improvement of clinical symptoms(postoperation and HBO treatment) and damage rating at present. Statistical software was used to analysis the correlation with the improvement rate after HBO of 6 influential factors including:age,trauma locus,injuried causes, onset of time of HBO therapy after operation, frequency of HBO therapy postoperation,degree of injury.Statistical processing:SPSS13.0 statistical software was used for data processing and statistical analysis. Measurement data were recorded by mean±standard deviation (x±s). These elements such as gender,trauma locus, injuried causes, degree of injury were compared by the Chi-Square test,while thoses elements such as age,the time of damage to the operation were compared by the t test.The differences between NHBO group and HBO group were compared by the Krudkal-Wallis H test(P<0.05). First,Single-factor analysis was carried out in each factors, comparation of count data between the three groups used multiple independent samples rank sum test(Krudkal-Wallis H test), comparation of count data between two groups used two independent samples rank sum test(Mann-Whitney U test),then binary Logistic regression analysis was used in the suspicious factors,with P<0.05 for significant difference.RESULTSAn average follow-up time was more than 6 months.132 cases were followed-up,12 cases were lost.Clinical therapeutic effect of HBO group obviously outweigh routine group(P< 0.05). The single factor analysis revealed that the three factors including onset of time of HBO therapy after operation, frequency of HBO therapy postoperation,admission to degree of injury can affect the therapeutic effect of Hyperbaric Oxygen on the patients with spinal cord injury.Group of onset of time of HBO therapy after operation (<=3)have the best results, group of onset of time of HBO therapy after operation (4-15) have the better results, group of onset of time of HBO therapy after operation (>15)have the worst results.Group of frequency of HBO therapy postoperation(>30) has the better results than group of frequency of HBO therapy postoperation(<=30). Group of imcomplete degree of injury has the better results than group of complete degree of injury. Multiple factors and Binary Logistic regression analysis shows influential factors affect the therapeutic effect are whether onset of time of HBO therapy after operation or not(P<0.05). The results of multiple factors and Binary Logistic regression analysis are slightly different from the single factor analysis',while the former's are more scientific and rational. To sum up,we determined that the three factors including onset of time of HBO therapy after operation, frequency of HBO therapy postoperation, degree of injury can affect the therapeutic effect, while the effect of the other factors including age, trauma locus,injuried causes had not statistically significant difference.CONCLUSIONClinical therapeutic effect of HBO group obviously outweigh NHBO group. HBO treatment was an effective and safe therapeutic method for the patients with spinal cord injury to promote visibly functional restoration of spinal cord, degrade the probability of disability, and significantly increase curative effect. So it can be a sort of adjunctive therapy. Hyperbaric oxygen therapy on incomplete spinal cord injury had new recovery. Hyperbaric oxygen therapy on complete spinal cord injury had almost no effect.Three factors including onset of time of HBO therapy after operation, frequency of HBO therapy postoperation,degree of injury were main elements of influencing curative effect,so they can supply references for clinical treatments.While the others have nothing with therapeutic effect.They involve age, trauma locus,injuried causes.