Objective To evaluate the effect of hyperbaric oxygen therapy (HBOT) in patients with severe traumatic brain injury (STBI) after craniotomy,and evaluate the difference of HBOT effects on the patients whose Glasgow coma score (GCS) were 6-8 scores and 3-5 scores.Methods Using case-control study,61 neurosurgical in-patients with STBl from February 6,2009 to November 25,2010 were divided into two groups by random digits table,30 in HBOT group and 31 in control group.Their GCS at the periods on admission,before HBOT and when they finished HBOT were recorded,as well as the Glasgow outcome score (GOS) before HBOT,finished HBOT,and 3 months after admission (GOS3M).Results The GCS finished HBOT were (12.63 ±2.70) scores in HBOT group and (11.64 ±2.50) scores in GCS 3-5 subgroup,there were statistically differences than those in control group [ (10.61± 3.01 ),(8.44 ± 1.67)scores] (P ＜0.05).The mean rank of GCS finished HBOT improvement (△GOSf) and GOS scores 3months after admission ( △ GOS3M) in HBOT group was 35.37 and 35.87,which were significantly higher than those in control group (26.77 and 26.29) (P ＜0.05).Meanwhile,the mean rank of △GOSf and △ GOS3M in GCS 3-5 subgroup was 12.14 and 13.09,which were significantly higher than those in control group (8.05 and 7.33) (P ＜ 0.05 ).In GCS 6-8 subgroup,there was no significant difference in △ GOSf and △ GOS3M between HBOT group and control group (P ＞ 0.05).Conclusion Early HBOT is effective to improve the recovery of consciousness and prognosis of the postoperative patient with STBI,especially of the patients with the special STBI (GCS 3-5 scores ).

Objective To investigate the potential clinical prognostic factors of severe traumatic brain injury.Methods Two hundred and thirteen severe traumatic brain injury patients,admitted to our hospital from May 2013 to July 2015,were chosen in our study.Their clinical data were retrospectively analyzed;prognostic factors,including age,gender,mGCS scores (movement GCS scores),improved CT scores,brain hernia,volume of intracranial hematoma,range of cerebral contusion and laceration,and location of intracranial hematoma,were estimated using Chi square test,and after the Chi square test,the factors enjoying statistical significance were analyzed by COX proportional hazards regression model.Results The mortality rate was 15.9％ (34/213).Death occurred within 30 days of admission,and death mostly occurred within 10 days of admission (1-10 d:23 patients;11-20 d:9 patients;20-30 d:2 patients).Cox proportional hazards regression analysis indicated that age,GCS scores (movement GCS scores),improved CT scores,and brain hernia were the prognostic risk factors in patients with severe traumatic brain injury,while gender,volume of intracranial hematoma,range of cerebral contusion and laceration,and location of intracranial hematoma were not.Conclusion Age,mGCS scores (movement GCS scores),improved CT scores,and brain hernia dare important factors affecting the prognosis of patients with severe traumatic brain injury.