Study on the analysis on the clinical effect of hyperbaric oxygen chamber in treating the postoperatively malignant brain edema of craniocerebral trauma

Ke WANG; Zhi-Jun BAO; Jun ZHANG

ABSTRACT

Objective:

To study the clinical effect of NBYY-BXDR-001 hyperbaric oxygen chamber in treating the postoperatively malignant brain edema of craniocerebral trauma,and the effects of that on the levels of matrix metalloproteinase-9(MMP-9),neutrophil gelatinase-associated lipocalin(NGAL),tenascin-C(TNC)and tumor necrosis factor-ɑ(TNF-ɑ).

Methods:

A total of 84 patients with postoperatively malignant brain edema of craniocerebral trauma who admitted to the hospital were selected,and they were divided into an observation group(45 cases received the interventional treatment of hyperbaric oxygen within postoperative 1-3 days)and a control group(39 cases received interventional treatment of hyperbaric oxygen within postoperative 4-10 days)according to the different therapeutic times of postoperative hyperbaric oxygen.The levels of serum MMP-9,NGAL,TNC and TNF-ɑof the two groups of patients were compared.The Glasgow Coma Scale(GCS)scores and the duration of brain edema of patients before and after treatment were recorded,and the mortality rates of the two groups of patients also were recorded.

Results:

There was no statistically significant difference in postoperative mortality rates between the two groups.The overall efficacy of the observation group was significantly better than that of the control group,and the difference was statistically significant(Z=-2.203,P<0.05).The GCS scores of the patients of the observation group at the 1st week,2nd week,3rd week and 4th week after surgery were significantly higher than that at the 1st d after surgery,and the differences were statistically significant(t=5.236,t=5.687,t=6.354,t=6.782,P<0.05),respectively.The serum MMP-9,NGAL,TNC and TNF-ɑ levels of the two groups of patients at the 1st week,2nd week,3rd week and 4th week after surgery were significantly lower than those at the 1st day after surgery,and the differences were statistically significant(Fobservation group= 125.127,F=98.224,F=137.791,F=105.226,Fcontrol group=113.370,F=73.363,F=115.520,F=84.069,P<0.05),respectively.At the 2nd,3rd and 4th week after surgery,the GCS scores of the observation group were significantly higher than those of the control group,and the serum MMP-9,NGAL,TNC and TNF-ɑ of the observation group were significantly lower than those of the control group,and the differences were statistically significant(tMMP-9=5.689,t=6.879,t=8.253,tNGAL=8.658,t=9.657,t=8.658,tTNC=6.587,t=6.354,t=6.859,tTNF-ɑ=7.898,t=8.654,t=8.256,P<0.05),respectively.Compared with the control group,the peak time and duration of brain edema of the observation group were significantly shortened,and the differences of them between two groups were statistically significant(t=2.064,t=-2.084,P<0.05),respectively.

Conclusion:

Early interventional treatment of hyperbaric oxygen in patients with postoperatively malignant brain edema of craniocerebral trauma can contribute to relieve postoperative brain edema and improve the treatment effect,which is related to the adjustment of hyperbaric oxygen for serum MMP-9,NGAL,TNC and TNF-ɑ levels.