摘要
目的:研究正中神经电刺激治疗创伤性持续植物状态的疗效与机制,同时探索创伤性持续植物状态的有效治疗方法。方法:66例创伤性持续植物状态患者随机分为3组,即正中神经电刺激组,高压氧组,正中神经电刺激+高压氧组。在药物治疗的基础上分别进行正中神经电刺激,高压氧和联合应用正中神经电刺激及高压氧治疗,治疗前后分别检测脑电图,体感诱发电位,脑干听觉诱发电位,同时行经颅多普勒检查患者大脑中动脉,基底动脉的平均血流速度,治疗后6个月时应用格拉斯哥(GOS)结果评分进行疗效评定。结果:治疗后6个月时GOS评定结果:正中神经电刺激组:恢复良好1例,中残7例,重残2例,植物状态11例,死亡1例。高压氧组:恢复良好1例,中残5例,重残3例,植物状态11例,死亡2例。正中神经电刺激+高压氧组:恢复良好3例,中残6例,重残4例,植物状态8例,死亡1例。3组比较差异无显著性意义(P>0.05)。正中神经电刺激组及正中神经电剌激+高压氧组大脑中动脉平均血流速度分别为(56.7±13.1)cm/s和(58.2±13.8)cm/s,较高压氧组的(48.6±12.2)cm/s明显加快(P<0.05)。正中神经电剌激+高压氧组基底动脉平均血流速度为(28.4±5.3)cm/s,较高压氧组的(25.1±4.9)cm/s明显加快(P<0.05)。结论:正中神经电刺激治疗创伤性持续植物状态的机制主要是加快脑血?
AIM:To study the therapeutic effect and mechanism of median nerve electrical stimulation in treatment of traumatic persistent vegetative state(PVS) and explore the effective treatment of traumatic PVS. METHODS:A total of 66 patients with PVS were divided randomly into 3 groups(digital method):median nerve electrical stimulation(MNS),hyperbaric oxygen(HBO) and MNS &HBO group.MNS,HBO and MNS &HBO were used respectively on the basis of medical treatment. Electroencephalography(EEG),sensory evoked potential(SEP) and brain stem auditory evoked potential(BAEP) were determinated before and after treatment. At the same time,mean blood flow rates of middle cerebral artery(MCA) and basilar artery(BA) were determinated with transcranial Doppler(TCD). Glasgow outcome scale(GOS) was used to evaluate the curative effects 6 months after treatment. RESULTS:The result of GOS after six month treatment:in MNS group, there was one patient with great recovery,seven patients with moderate disablement,two patients with severe disability,eleven patients with persistent vegetative state,and one patient with death.In HBO group,there was one patient with great recovery,five patients with moderate disablement,three patients with severe disability,eleven patients with persistent vegetative state,and two patients with death.In the MNS &HBO group,there was three patients with great recovery,six patients with moderate disablement,four patients with severe disability,eight patients with persistent vegetative state, and one patient with death.It was not significantly different among three groups(P >0.05).The mean blood flow rates of MCA were(56.7±13.1) cm/s and(58.2±13.8) cm/s,respectively,in MNS group and MNS &HBO group, which was obviously higher than that in HBO group[(8.6±12.2) cm/s,P< 0.05].The mean blood flow rates of BA was(28.4±5.3) cm/s in the MNS &HBO group,which was significantly higher than that in HBO group [(5.1±4.9) cm/s,P< 0.05]. CONCLUSION:The main mechanism of MNS in treatment of traumatic PVS is to improve patients'
出处
《中国临床康复》
CSCD
2004年第28期6040-6043,共4页
Chinese Journal of Clinical Rehabilitation
