Effects of hyperbaric oxygen preconditioning on the cognitive function of elderly patients with lower extremity fracture after surgery

Abstract

Objective To investigate clinical effects of hyperbaric oxygen (HBO) preconditioning on the cognitive function of elderly patients with lower extremity fracture after surgery and possible mechanism involved. Methods One hundred patients with lower extremity fracture treated in our hospital from January 2015 to January 2019 were enrolled for study and were randomly divided into the observation group and the control group, each consisting of 50 patients. All the patients in the 2 groups received conventional surgery, with the patients in the observation group undergoing hyperbaric oxygen (HBO) preconditioning before surgery. Then, cognitive function of the patients in both groups was closely observed after surgery, and changes in the levels of neuron specific enolase (NSE), NSE/S-100β protein and brain injury indexes were detected. Results Seventy-two hours after surgery, the MMSE scores of the patients in the 2 groups decreased to a certain extent, with the mini-mental state examination (MMSE) scores of the observation group being higher than those of the control group. Statistical significance could be found when comparisons were made between the 2 groups(P<0.05). After treatment, serum levels of NSE and S-100β protein in the 2 groups all obviously increased, with NSE and S-100β levels of the observation group being considerably lower than those of the control group. Statistical significance could be noted when comparisons were made between them (P<0.05 or P<0.01). Brain injury factors Tau protein, pTau protein and Aβ1-42 protein in the patients of the 2 groups all elevated, with those of the observation group being significantly lower than those of the control group. Statistical significance could also be noticed when comparisons were made between them (P<0.05 or P<0.01). However, there was no statistical significance in rates of adverse reactions between the observation group (20.0%)and the control group (24.0%). Conclusion Hyperbaric oxygen preconditioning before surgery could help to improve cognitive function of the patients with lower extremity fracture after surgery and decrease the expression levels of NCE, S-100β inflammatory mediator and brain injury factor, thus alleviating brain injury and promoting recovery of brain function. Key words: Hyperbaric oxygen; Preconditioning; Lower extremity fracture surgery; Cognitive function