正中神经电刺激对脑外伤后昏迷患者促醒作用的临床及机制研究

发布时间：2018-05-17 15:01

本文选题：脑外伤 + 正中神经电刺激　；参考：《中国康复医学杂志》2016年11期

【摘要】：目的:探讨正中神经电刺激(median nerve electrical stimulation,MNS)对脑外伤(traumatic brain injury,TBI)后昏迷患者的促醒作用及可能机制。方法:将60例脑损伤后昏迷患者随机分为试验组(n=30)和对照组(n=30),两组均给予常规促醒治疗,试验组在常规治疗的基础上加用MNS治疗。两组治疗前后均行格拉斯哥昏迷评分(Glasgow coma scale,GCS)和脑电图(electroencephalograph,EEG)及单光子发射计算机化断层显像(SPECT)检查。结果:治疗4W后试验组平均GCS评分明显优于对照组,差异有显著性意义(P0.05);试验组脑电图病灶侧δ/θ活动减少,α波波幅降低;SPECT视觉分析表明治疗后试验组病灶区脑血流量较治疗前明显增加,半定量分析显示病灶区(右ROI—左ROI)/右ROI%也较治疗前平均提高12.34%±0.36%,差异有显著性意义(P0.05)。结论:MNS对TBI后昏迷患者具有促醒作用,其机制可能与病灶区脑血流灌注增加有关。
[Abstract]:Objective: to investigate the effect of median nerve electrical stimulation (MNSN) on the wake-up of coma patients after traumatic brain injury-induced by brain trauma and its possible mechanism. Methods: sixty patients with coma after brain injury were randomly divided into two groups: the experimental group (n = 30) and the control group (n = 30). Both groups were given routine wake-up therapy. The experimental group was treated with MNS on the basis of routine treatment. Before and after treatment, Glasgow coma scale (Glasgow), electroencephalography (EGG) and single photon emission computed tomography (SPECT) were performed in both groups. Results: the average GCS score of the trial group was significantly better than that of the control group after 4 weeks of treatment. The results of SPECT visual analysis showed that the cerebral blood flow (CBF) in the focus area of the experimental group was significantly higher than that before treatment, and the activity of 未 / 胃 was decreased and the amplitude of 伪 wave was decreased by SPECT in the experimental group. Semi-quantitative analysis showed that the lesion area (right ROI- left ROI)/ right ROI%) was also increased by 12.34% 卤0.36% compared with that before treatment, and the difference was significant (P 0.05). Conclusion the effects of WMNS on the recovery of coma patients after TBI may be related to the increase of cerebral blood flow perfusion in the focal area.
【作者单位】：南昌大学第一附属医院;
【基金】：国家自然科学基金项目(81260295) 江西省自然科学基金项目(20132BAB205063)
【分类号】：R651.15

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