53例重型颅脑损伤长期昏迷病人的催醒效果

Effect of arousal methods for 53 cases of prolonged coma after severe traumatic brain injury

目的介绍53例重型颅脑损伤持续昏迷1个月以上病人的催醒效果和影响催醒效果的因素。方法伤后昏迷时间1￣12个月、GCS≤8分的重型颅脑损伤病人53例,采用高压氧、理疗、药物等综合催醒方法治疗。结果53例长期昏迷病人中,28例苏醒(52.8%)。按照GOS评分,28例清醒病人中仅6例恢复良好和中残(21.4%),其他22例病人为重残、无自主生活能力(78.6%)。苏醒成功率与病人是否有原发性脑干伤、脑疝、GCS评分、年龄等因素有关。结论采用综合催醒方法,能提高长期昏迷病人苏醒成功率,但神经功能恢复仍十分困难。

Objective To determine the effect of arousal methods on prolonged coma of 53 patients with severe traumatic brain injury and relative factors. Methods 53 cases with persistent coma 1~12 months after severe traumatic brain injury,and GCS≤8,were treated with arousal procedures including hyperbaric oxygen,physical therapy and drugs. Results 28 patients got recovery of consciousness in 53 prolonged coma(52.8%),Only 6 cases got good recovery or moderate deficits(21.4%),and the other 22 awake patients had severe deficits(78.6%). Recovery of consciousness depended on patient’s primary brain stem damage,cerebral hernia,GCS score,and age,etc. Conclusion Application of correct arousal procedures can improve recovery of consciousness in patients with prolonged coma; however,improvement of neurological functions is still difficult.