Effect of ligustrazine hydrochloride injection combined with hyperbaric oxygen therapy on postoperative complications, cerebral blood flow, and serum levels of sFKN and HMGB1 in patients with severe traumatic brain injury

Abstract

Objective: To investigate the effects of ligustrazine hydrochloride injection combined with hyperbaric oxygen therapy on postoperative complication rates, cerebral blood flow, and serum levels of soluble fractalkine (sFKN) and high mobility group box protein 1 (HMGB1) in patients with severe traumatic brain injury (STBI).

Methods: A total of 102 patients with severe TBI, treated at our hospital from February 2020 to February 2023, were randomly assigned into two groups using a sealed envelope method. Each group consisted of 51 patients. Both groups underwent decompressive craniectomy. The control group received hyperbaric oxygen therapy, while the observation group received ligustrazine hydrochloride injection combined with hyperbaric oxygen therapy, with treatment lasting for 1 month. The degree of National Institutes of Health Stroke Scale (NIHSS), Glasgow Coma Scale (GCS), Mini- Mental State Examination (MMSE), cerebral blood flow parameters (vertebral artery [VA], basilar artery [BA], middle cerebral artery [MCA], anterior cerebral artery [ACA], posterior cerebral artery [PCA] blood flow velocities), serum brain injury markers (S100β protein, neuron-specific enolase [NSE], glial fibrillary acidic protein [GFAP]), and serum levels of sFKN and HMGB1 were compared before and 1 month after treatment. The incidence of postoperative complications and the 6-month prognosis were also recorded.

Results: One month after treatment, the observation group showed significantly lower NIHSS scores and higher GCS and MMSE scores compared to the control group (P < 0.05). Blood flow velocities in the VA, BA, MCA, ACA, and PCA were significantly lower in the observation group than in the control group (P < 0.05). Additionally, serum levels of S100β, NSE, and GFAP were significantly lower in the observation group (P < 0.05). Serum levels of sFKN and HMGB1 were also significantly lower in the observation group (P < 0.05). The incidence of hydrocephalus, postoperative seizures, brain herniation, and cerebral vasospasm was significantly lower in the observation group (P < 0.05). At 6 months post-treatment, the observation group had a better overall prognosis than the control group (P < 0.05).

Conclusion: Ligustrazine hydrochloride injection combined with hyperbaric oxygen therapy significantly improves cerebral blood flow, reduces serum levels of sFKN and HMGB1, alleviates brain injury, enhances neurological recovery, and effectively reduces postoperative complications, leading to improved long-term prognosis in patients with STBI.