正中神经电刺激对脑损伤后昏迷患者血流动力学的影响

发布时间：2018-05-14 21:52

本文选题：重型颅脑损伤 + 昏迷　；参考：《华中科技大学学报(医学版)》2017年04期

【摘要】：目的探讨正中神经电刺激疗法对重型颅脑损伤后昏迷患者的疗效及脑血流动力学影响。方法选取2016年1月~2016年12月淮安市第一人民医院神经外科收治的112例重型颅脑损伤后昏迷患者,随机分为实验组、对照组,每组各56例,均接受基础治疗,实验组在术后1周接受正中神经电刺激治疗。结果 2个组别治疗及随访期间无死亡病例。治疗前,2个组别的大脑中动脉血流动力学、格拉斯哥昏迷评分(GCS)和神经功能障碍评分(DRS)及听觉脑干诱发电位差异无统计学意义(均P0.05)。治疗后及随访2个月,2个组别的血流速度(Vs)、平均血流速度(Vm)和GCS评分显著增高(均P0.05),搏动指数(PI)、DRS评分和听觉脑干诱发电位显著降低(均P0.05)。治疗后,与对照组比,实验组的Vs、Vm和GCS评分显著增高(均P0.05),PI、DRS评分和听觉脑干诱发电位显著降低(均P0.05);随访2个月,2个组别的大脑中动脉血流动力学、GCS和DRS评分及听觉脑干诱发电位差异无统计学意义(均P0.05)。结论重型颅脑损伤后昏迷患者采用正中神经电刺激对患者苏醒及脑血流动力学均具有显著的改善作用。
[Abstract]:Objective to investigate the effect of median nerve electrical stimulation on coma patients after severe craniocerebral injury and the effect of cerebral hemodynamics. Methods from January 2016 to December 2016, 112 patients with coma after severe craniocerebral injury in the Department of Neurosurgery, first people's Hospital of Huaian City, were randomly divided into two groups: experimental group (n = 56) and control group (n = 56). The experimental group was treated with median nerve stimulation 1 week after operation. Results there were no death cases in 2 groups during treatment and follow-up. Before treatment, there were no significant differences in hemodynamics of middle cerebral artery, Glasgow coma score (GCSS), neurological dysfunction score (DRS) and auditory brainstem evoked potential (ABAEP) in two groups (P 0.05). After treatment and follow-up for 2 months, the blood flow velocity and mean blood flow velocity (Vm) and GCS scores in the two groups were significantly increased (all P 0.05), and the pulsatility index (Pi) and auditory brainstem evoked potentials (BAEP) were significantly decreased (all P 0.05). After treatment, compared with the control group, The scores of VSV m and GCS in the experimental group were significantly higher than those in the control group (P 0.05) and the scores of auditory brainstem evoked potentials (BAEP) and the scores of DRS and the scores of GCS and DRS in the middle cerebral artery of the two groups were significantly lower than those in the control group (P 0.05). There was no statistical significance (P 0.05). Conclusion median nerve stimulation can significantly improve the recovery and cerebral hemodynamics of coma patients after severe craniocerebral injury.
【作者单位】：南京医科大学附属淮安市第一人民医院神经外科;
【分类号】：R651.15

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