摘要
背景脑出血后患者极易发生睡眠-醒觉行为紊乱,延缓预后进程,长期应用药物容易产生耐受性。经Tomatis高-低频转换处理的音乐训练可刺激、丰富人耳和神经系统之间的互联,进而调节睡眠结构。目的探讨Tomatis高-低频转换听觉训练对急性期脑出血患者睡眠结构的影响。方法选取2017年7月2018年7月在华北理工大学附属医院神经外科治疗的138例急性期脑出血睡眠障碍患者为研究对象,并将其按随机数字表法分为对照组、音乐组、听觉训练组,每组46例,对照组实施日常护理,音乐组在日常护理的基础上进行常规音乐训练,听觉训练组在日常护理的基础上进行经处理的Tomatis高-低频转换听觉训练,连续干预14 d,采用多导睡眠监测(PSG)记录数据,比较三组患者干预前后睡眠结构的差异。结果三组患者干预后非快速动眼睡眠(NREM)潜伏期、快速动眼睡眠(REM)潜伏期、NREM持续时间占总睡眠时间比例、3期睡眠时间占总睡眠时间比例、4期睡眠时间占总睡眠时间比例、REM时间占总睡眠时间比例比较,差异均有统计学意义(P<0.05)。对照组在各个方面与干预前比较,差异均无统计学意义(P>0.05);音乐组干预后4期睡眠时间占总睡眠时间比例较干预前延长(P<0.05);听觉训练组干预后总睡眠时间占总记录时间比例、3期睡眠时间占总睡眠时间比例、4期睡眠时间占总睡眠时间比例、REM时间占总睡眠时间比例较干预前延长,NREM潜伏期、NREM持续时间占总睡眠时间比例较干预前减少(P<0.05)。三组患者在NREM潜伏期、NREM持续时间占总睡眠时间比例、慢波睡眠(3期和4期睡眠)时间占总睡眠时间比例、REM时间占总睡眠时间比例差值比较,差异均有统计学意义(P<0.05)。其中音乐组在4期睡眠时间占总睡眠时间比例差值的绝对值高于对照组,听觉训练组在NREM持续时间占总睡眠时间比例、慢波睡眠(3期和4期睡眠
Background Sleep-wake disorders are most likely to occur in patients after cerebral hemorrhage,which can delay the recovery process.But long-term pharmaceutical treatment can cause low response.Tomatis listening therapy can stimulate and improve the interconnections between human ears and the nervous system,thereby regulating the sleep structure via listening to the music consisting of sounds with the sudden transition from low-to-high frequencies and vice versa.Objective To explore the effect of Tomatis listening therapy on sleep structure in patients with acute cerebral hemorrhage.Methods 138 patients with sleep disorders after acute cerebral hemorrhage were recruited from Neurosurgery Department,North China University of Science and Technology Affiliated Hospital,from July 2017 to July 2018.By use of a table of random numbers,they were equally divided into control group,music therapy group,and listening therapy group,receiving conventional nursing,conventional nursing and common music therapy,conventional nursing in combination with Tomatis listening therapy(listening to the music consisting of sounds with the sudden transition from low-to-high frequencies and vice versa),respectively.The intervention lasted for consecutive 14 days for all participants.Sleep quality data were collected by overnight PSG monitoring.Sleep structure was compared between the groups before and after intervention.Results There were significant differences in non-REM latency,REM latency,ratios of non-REM latency to total sleep time,stage 3 non-REM sleep time to total sleep time,stage 4 non-REM sleep time to total sleep time,and REM sleep time to total sleep time after intervention among three groups(P<0.05).Self-controlled comparisons showed that,compared with baseline,after intervention,sleep quality changed insignificantly in the control group(P>0.05);ratio of stage 4 non-REM sleep time to total sleep time increased in music therapy group(P<0.05);ratios of total sleep time to total recording time,stage 3 non-REM sleep time to total
作者
成杰
王倩
董立焕
王卫亮
CHENG Jie;WANG Qian;DONG Lihuan;WANG Weiliang(North China University of Science and Technology Affiliated Hospital,Tangshan 063000,China;North China University of Science and Technology,Tangshan 063210,China)
出处
《中国全科医学》
CAS
北大核心
2019年第26期3165-3170,共6页
Chinese General Practice
基金
河北省教育厅基金(Z2017015)
中国煤炭工业协会(MTKJ 2016-352)
