摘要
目的利用18氟脱氧葡萄糖（18F—FDG）正电子发射计算机断层显像（PET）测定重型颅脑外伤患者高压氧治疗前、后脑葡萄糖代谢水平，从而探讨高压氧治疗脑外伤患者的相关机制。方法共选取26例发病2周内、生命体征稳定的重型颅脑外伤患者，将其随机分为高压氧组及对照组。2组患者均给予临床常规干预（包括护脑、脱水、降颅压、抗感染以及相应对症处理等），高压氧组在此基础上辅以高压氧治疗，每天治疗1次，每周治疗7d。所有患者于治疗前及治疗4周后分别进行PET—CT扫描，另同时采用格拉斯哥昏迷量表（GCS）及残疾分级量表（DRS）对2组患者进行疗效评定。结果入选时所有患者PET—CT扫描显示其正常脑区与损伤脑区标准吸收值（SUV）间差异有统计学意义（P〈0．01），上述脑区SUV值组间差异则无统计学意义（P〉0．05）；经4周治疗后，发现2组患者正常脑区及损伤脑区SUV值均有一定程度提高，其中以高压氧组损伤脑区SUV值改善幅度尤为显著，明显优于入选时及对照组水平（P〈0．01）；同时高压氧组GCS及DRS评分亦显著优于对照组（P〈0．05）。结论通过18F—FDGPET—CT检查发现，高压氧治疗能显著改善重型颅脑外伤患者损伤脑区葡萄糖代谢功能，对促进大脑功能恢复、加速患者觉醒、改善预后等均具有重要意义。
Objective By using 18 F-deoxyglucose （18 F-FDG） positron emission computed tomography （PET-CT） to measure the brain glucose metabolism of patients with severe traumatic brain injury before and after hyperbaric oxygen （HBO） therapy, and to investigate the mechanisms of HBO treating patients with traumatic brain injury. Methods Twenty-six patients suffered form severe traumatic brain injury with stable vital signs within 2 weeks were randomly divided into the HBO group and the control group. The patients of both groups received routine clinical interventions （ including neuroprotection, dehydration, reducing intracranial pressure, anti-infection and other symptomatic treatments）. Patients of the HBO group received the basic treatment combined with HBO therapy one time per day for 7 days per week. In early stage and 4 weeks after treatment, all patients were examined with PET-CT scanning and Glasgow coma scale （GCS） ,disability rating scale （DRS） at the same time. Results There was standard uptake value （SUV） of significant difference between affected and unaffected brain areas in two groups before treatment（ P 〈 0. 01 ） , but no significant difference between two groups （P 〉 0.05 ）. After 4-week of treatment, SUV of affected and unaffected brain areas of two groups improved, the damaged area of HBO group improved obviously and the SUV was much better than before treatment and the control group （P 〈 0.01 ）. The GCS and DRS scores of HBO group were also significantly better than that of control group （ P 〈 0. 05 ）. Conclusion The 18 F-FDG PET-CT examination showed that HBO therapy can significantly improve glucose metabolism function of the brain damaged area, promote the brain functional recovery and awakening, and improve the prognosis in patients with severe traumatic brain injury.
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2012年第6期440-443,共4页
Chinese Journal of Physical Medicine and Rehabilitation
关键词
高压氧
颅脑损伤
正电子发射断层显像术
Hyperbaric oxygenation
Craniocerebral trauma
Positron emission tomography
