王碰起,魏梁锋,周苏键,等.高压氧治疗对亚急性期创伤性脑损伤患者腺垂体功能的影响[J].中华物理医学与康复杂志,2020,42(8):712-715
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| 高压氧治疗对亚急性期创伤性脑损伤患者腺垂体功能的影响 |
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| DOI：10.3760/cma.j.issn.0254-1424.2020.08.010 |
| 中文关键词: 创伤性脑损伤 高压氧 腺垂体功能低下 血清激素 |
| 英文关键词: Brain trauma Hyperbaric oxygen Hypopituitarism Serum hormones |
| 基金项目:南京军区福州总医院创新团队基金(2014CXTD07) ；福建省科技计划引导性项目（2018Y0067） |
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| 中文摘要: |
| 目的 观察高压氧（HBO）治疗对亚急性期创伤性脑损伤（TBI）患者腺垂体功能的影响。 方法 采用随机数字表法将66例亚急性期TBI腺垂体功能低下患者分为对照组及HBO组，每组33例。2组患者均给予常规治疗（包括脱水降颅压、抗感染、预防癫痫、预防褥疮、营养神经、补液及康复治疗等），HBO组在此基础上辅以HBO干预，HBO治疗压力为0.2 MPa(2.0 ATA)，每日治疗1次，每周治疗6次，共治疗20次。于治疗前、治疗20次后采用化学发光免疫分析法检测患者血清中促肾上腺皮质激素（ACTH）、生长激素（GH）、促甲状腺激素（TSH）、催乳素（PRL）、黄体生成素（LH）、卵泡刺激素（FSH）、皮质醇（COR）、胰岛素样生长因子-1（IGF-1)、游离四碘甲状腺原氨酸（FT4）、睾酮（TES）及雌二醇（E2）水平，对ACTH、GH、TSH、PRL、LH、FSH赋值并计算垂体总体激素评分。 结果 治疗20次后发现HBO组PRL、LH、TES的对数值及垂体总体激素评分［分别为（1.3±0.2）μg/L、（1.0±0.4）mU/L、（2.5±0.2）ng/dl和（22.0±2.6）分］均显著高于对照组水平［分别为（1.1±0.2）μg/L、（0.8±0.3）mU/L、（2.4±0.3）ng/dl和（20.5±2.3）分］，组间差异均具有统计学意义(P＜0.05)。 结论 在常规干预基础上辅以HBO治疗能进一步提高亚急性期TBI患者多种激素水平，促进垂体功能恢复。 |
| 英文摘要: |
| Objective To observe the effect of hyperbaric oxygen (HBO) therapy on the pituitary function of patients with subacute traumatic brain injury. Methods Sixty-six patients with subacute traumatic brain injury and hypopituitarism were randomly divided into a control group (n=33) and an HBO group (n=33). Patients in both groups were given conventional treatment including dehydration to reduce intracranial pressure, anti-infection medication, epilepsy and bed sores prevention measures, neurotrophic treatment, fluid replacement and rehabilitation. The HBO group was additionally given HBO at 0.2MPa (2.0ATA), once a day, 6 times a week for a total of 20 administrations. Before and after the treatment, serum adrenocorticotropic hormone (ACTH), growth hormone (GH), thyroid stimulating hormone (TSH), prolactin (PRL), luteinizing hormone (LH), follicle stimulating hormone (FSH), cortisol, insulin-like growth factor 1, free tetraiodothyronine, testosterone, and estradiol levels were detected using chemical immunoluminescence. The ACTH, GH, TSH, PRL, LH and FSH values were used to calculate general pituitary hormone scores. Results After the treatment, the average PRL, LH and testosterone levels and the general pituitary hormone score in the HBO group were significantly higher than among the controls. Conclusions HBO treatment can increase the levels of various hormones in patients with subacute traumatic brain injury and promote the recovery of pituitary function. |
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