经颅电刺激小脑顶核对脑损伤后意识障碍患者脑血流速度及神经电生理的影响

Effect on cerebral blood flow velocity and electroneurophysiology in unconscious patients with brain injury after transcranial fastigial nucleus stimulation

目的:研究经颅电刺激小脑顶核对脑损伤后意识障碍患者脑血流速度及神经电生理的影响,以探索其可能的促苏醒作用。方法:将30例脑损伤后意识障碍患者随机分为治疗组(n=15)和对照组(n=15),两组均给予常规促醒治疗,治疗组在常规治疗的基础上加用小脑顶核电刺激治疗,两组治疗前后均行脑电图、脑干听觉诱发电位检查,同时行经颅多普勒脑血管超声检测患者大脑中动脉、基底动脉平均血流速度。治疗后行GCS意识障碍评分进行疗效评定。结果:治疗50 d后治疗组脑电图与对照组相比,差异有统计学意义(P<0.05),治疗组脑电图慢波减少,出现α节律或α节律增多,波幅增高。治疗后两组脑血流速度及脑干听诱发比较,差异无统计学意义(P>0.05)。治疗50 d后两组GCS评分比较,差异有统计学意义(P<0.05)。结论:经颅电刺激小脑顶核能改善脑损伤后意识障碍患者的脑电活动,对意识障碍患者可能有促苏醒作用。

Objective： To investigate the therapeutic effect on cerebral blood flow velocity and electroneurophysiology in unconscious patients with brain injury after fastigial nucleus stimulation,and to explore the possible mechanism of its hastening awakening from unconscious.Methods： 30 unconscious patients with brain injury were randomly assigned to the treatment group（n=15） and the control group（n=15）.The patients in the control group were treated routinely.Besides routine therapy the patients in the treatment group were treated with fastigial nucleus stimulation.Electroencephalography（EEG） and brain stem auditory evoked potential（BAEP） were determinated before and 50 days after treatment,at the same time,mean flow rates of middle cerebral artery（MCA） and basilar artery（BA） were determinated with transcranial Doppler（TCD）,Glasgow scale（GCS） was used to evaluate the curative effect after treatment.Results： After 50-days treatment,in the treatment group,test results showed improvement in EEG compared with the conrtol group（P0.05）,ECG slow wave decreased,α rhythm incurred or increased and volatility increased in the treatment group.There was no significant difference in BAEP or in the mean flow rates of cerebral artery（P0.05）;after treatment,the GCS score in the treatment group was increased than control group（P0.05）.Conclusion： The therapy of fastigial nucleus stimulation can improve the electroencephalography in unconscious patients with brain injury,and maybe it can help those patients awaken from unconscious.