The Effect Of Hyperbaric Oxygen Therapy On Patients With Traumatic Brain Injury And On The Burden Of Caregivers

objective: To study the effect of hyperbaric oxygen therapy on patients with traumatic brain injury and the improvement of the burden on caregivers.Methods :(1)This study was a prospective cohort study which was held in the Department of Hyperbaric Oxygen,Neurosurgery of Sichuan Provincial People's Hospital and Bayi Rehabilitation Center.Patients with traumatic brain injury were included from December 2017 to December 2018,and was divided into two groups: hyperbaric oxygen group or non-hyperbaric oxygen group according to whether he/she received hyperbaric oxygen therapy.Collect demographic and medical history data of the patient,such as name,gender,age,cause of injury,baseline Glasgow Coma Scale(GCS)score,past medical history,personal history(smoking history,alcohol history),baseline blood test results(White blood cell count and platelet),treatment plan during hospitalization,duration of hyperbaric oxygen therapy,and time and number of hyperbaric oxygen therapy.(2)Regular following-up of all patients included,record the number of hospital stays,the main treatment after discharge,the level of consciousness in the first month and the third month after injury(Glasgow Coma Scale: GCS),sixth month(Glasgow prognosis score:GOS),caregiver burden survey in the first month,third month,and sixth month after injury(Zarit Caregiver Burden Scale: ZBI).(3)Statistical analysis was performed using SPSS 20.0.The measurement data is represented by the mean ± standard deviation(sX ±),and the count data is represented by the number of cases and the composition ratio(n,%).The normal distribution data comparison uses the independent sample t test,the non-normal distribution data comparison uses the non-parametric test,and the count data comparison uses the chi-square test: when the theoretical frequency(T)<5 appears in the four tables,the four-grid table is used.Probability method.Univariate analysis was performed on various influencing factors to understand the factors affecting follow-up indicators.Multivariate analysis was performed on factors with P<0.1,confounding factors were adjusted,and independent influencing factors were determined.For multivariate analysis,the dependent variable was a binary categorical variable and binary logistic regression analysis was used(P<0.05,the difference was considered statistically significant).(4)Univariate logistic regression was performed on various factors that may affect patients' adverse outcomes,mortality,and ZBI scores.P<0.1 factors were included in multivariate logistic regression equation analysis,and confounding factors were adjusted to determine independent influencing factors.Results:1.A total of 178 patients with traumatic brain injury were enrolled.Two patients were lost to follow-up.This study included 176 patients with traumatic brain injury,including 136 males(77.3%)and 40 females(22.7).%),the mean age of the hyperbaric oxygen group was 44.8±17.5 years,and the mean age of the non-hyperbaric oxygen group was 47.5±23.0 years.2.The GCS score of the hyperbaric oxygen group was higher in the third month than in the non-hyperbaric oxygen group,and there was a statistical difference.Further,single factor and multivariate regression analysis showed that hyperbaric oxygen therapy was an independent influencing factor affecting the GCS score.3.There was a statistically significant difference in adverse outcomes and mortality between the two groups at the sixth month.Multivariate logistic regression analysis found that hyperbaric oxygen therapy and baseline GCS score were the sixth month of bad outcome and independent mortality.Influencing factors.4.In the univariate analysis,hyperbaric oxygen therapy was the factor affecting the ZBI score in the sixth month.Multivariate logistic regression showed that the baseline GCS score and hospitalization days were independent influencing factors of the sixth month ZBI score.Hyperbaric oxygen therapy did not have an independent effect on the ZBI score for the sixth month.Conclusion: 1.Hyperbaric oxygen therapy can improve the level of consciousness of patients with traumatic brain injury,reduce the occurrence of bad outcomes and reduce mortality.2.Hospitalization time can affect the burden of caregivers,hyperbaric oxygen therapy failed to reduce the burden of caregivers of patients with traumatic brain injury.