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目的探讨高压氧治疗重型颅脑损伤的疗效及机制。方法重型颅脑损伤患者35例为治疗组，20例为对照组，观察高压氧治疗前后临床(GCS)、脑电地形图 (BEAM)、血内皮素(ET)、经颅多普勒超声(TCD)及预后(GOS)的变化。 结果治疗组患者经高压氧治疗后临床(GCS)、脑电地形图及预后均明显改善，与对照组相比有统计学意 义。高压氧治疗1个疗程后，治疗组血内皮素由91.24±12.18ng/L下降到68.88±14.37ng/L(P＜0.01)； 经颅多普勒超声示大脑中动脉Vm也由64.2±4.8cm/s下降到51.6±4.2cm/s(P＜0.01)；同时，大脑中动 脉VsPI也明显下降。统计学有显著性意义(P＜0.01)。 结论高压氧治疗能够明显改善重型颅脑损伤患者的临床、脑电地形图及预后，并且通过降低急性期血内 皮素、改善大脑中动脉血流速度及血管阻力来改善重型颅脑损伤后脑血管痉挛及脑缺血缺氧。同时，降低 颅内压是高压氧治疗重度颅脑损伤的重要机制之一。

Objective To analyze the effect and mechanism of hyperbaricoxygen (HBO) treatment for severe brain injury (SBI). Methods Fifty-five patients were divided into a treatment group of 35 patients and a control group of 20 patients. We observed the alterations of clinical, brain electric earth map (BEAM), endothelin (ET) and transcranial ultrasonic Doppler (TCD) findings before and after HBO treatment as well as outcome. Results In the treatment group, Glasgow coma scale, BEAM and outcome improved after HBO treatment; compared with that of the control group, it showed a significant difference. After one course of treatment, treatment group ET was reduced from 91.24±12.18?ng/L to 68.88±14.37?ng/L (P<0.01); in control group, ET was reduced from 90.78±15.71?ng/L to 83.12±12.22?ng/L, with a statistically significant difference (P<0.05). TCD records of MCA mean velocity (Vm) was reduced from 64.2±4.8?cm/s to 51.6±4.2?cm/s (P<0.01), and a decrease in MCA systolic velocity (Vs) and pulse index (PI) values was statistically significant (P<0.01). Conclusion HBO treatment can improve the clinical, BEAM and outcome of severely brain injured patients, by decreasing acute stage ET and improving the blood velocity of MCA and decreasing cerebral vascular resistance. HBO treatment can reduce cerebral vascular spasms, cerebral ischemia and hypoxia. One of the important mechanisms of HBO treatment for severe brain injury is the lowering of intracranial pressure.