摘要
目的通过分析高压氧(HBO)综合康复治疗长期意识障碍患者的临床疗效,探讨中国南京持续植物状态量表(CNPVSS)对长期意识障碍患者疗效的预评估价值。方法选择2016年9月至2019年5月入住南京紫金医院接受HBO综合康复治疗且符合分析标准的长期意识障碍患者48例,治疗前给予CNPVSS评分,治疗初期给予脑电图(EEG)和诱发电位(EPs)检查,出院前再次评估意识状态,统计并分析CNPVSS评分、电生理检测指标与患者意识转归的相关性。结果CNPVSS评分结果与患者近期疗效呈正相关(r=0.401,P=0.005);CNPVSS评分为微小意识状态(MCS)患者经治疗后神志转清率为46.2%,植物状态(VS)或昏迷者神志转清率为17.1%;MCS患者经治疗后意识转清率高于VS和昏迷患者(χ^2=4.255,P=0.039)。右脑体感诱发电位(SSEPs)N20结果与临床疗效呈正相关(r=0.312,P=0.031);左侧视觉诱发电位(VEPs)V100结果与临床疗效呈正相关(r=0.285,P=0.049),而与其他电生理指标无明显相关性(P>0.05)。结论CNPVSS评分可作为判断HBO综合康复治疗长期意识障碍患者疗效的重要参考指标,SSEPs和VEPs指标对判断预后也有一定的参考价值。
Objective To explore the predictive value of China Nanjing persistent vegetative state scale(CNPVSS)on the curative effect of the patients with chronic disorder of consciousness,by analyzing the curative effect of the rehabilitation treatment combined with hyperbaric oxygen(HBO)for patients with chronic disorder of consciousness.Methods A total of 48 patients with chronic disorder of consciousness admitted to Nanjing Zijin Hospital to receive rehabilitation treatment combined with HBO from the September of 2016 to the May of 2019 were selected according with the analytical criteria.Before the treatment,the patients were evaluated by CNPVSS and received electroencephalogram(EEG)and evoked potentials(EPs)examinations.The patients'consciousness was evaluated again before discharge,the results of CNPVSS and electrophysiological examinations were recorded,and the correlation between the results and the changes of the consciousness was analyzed statistically.Results The results of CNPVSS was positive correlated with near-term curative effect(r=0.401,P=0.005);the rate of awakening after treatment was 46.2%among those who were scored as minimally conscious state(MCS)by CNPVSS;the rate of awakening after treatment was 17.1%among those who were at vegetative state(VS)or in a coma;the rate of awakening after treatment of the MCS patients was higher than those of the patients at VS or in a coma(χ^2=4.255,P=0.039).The recordings of right somatosensory evoked potentials(SSEPs)N20 was positive correlated with curative effect(r=0.312,P=0.031);and the left visual evoked potentials(VEPs)V100 was positive correlated with curative effect(r=0.285,P=0.049).There were no statistical significance found between other electrophysiological recordings with curative effect.Conclusion CNPVSS can be an important tool to predict the outcome of the rehabilitation treatment combined with HBO for the patients with chronic disorder of consciousness,and the recordings of SSEPs and VEPs also are of a certain reference value in predicting the prognos
作者
高志强
刘亚峰
戚玉亮
潘兴明
高继荣
王爱萍
马虎龙
彭向荣
徐婷婷
王霞
Gao Zhiqiang;Liu Yafeng;Qi Yuliang;Pan Xingming;Gao Jirong;Wang Aiping;Ma Hulong;Pen Xiangrong;Xu Tingting;Wang Xia(Nanjing Zijin Hospital,Nanjing 211100,China)
出处
《中华航海医学与高气压医学杂志》
CAS
CSCD
2020年第4期489-492,共4页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
关键词
中国南京持续植物状态量表
高压氧
意识障碍
脑电图
诱发电位
China Nanjing persistent vegetative state scale
Hyperbaric oxygen
Disorder of consciousness
EEG
EPs
