微意识状态与持续植物状态疗效的对比研究

Treatment efficacy of patients with minimally conscious state and persistent vegetative state： a comparative study

目的探讨微意识状态（MCS）与持续植物状态（pvs）患者疗效的差异。方法深圳市第三人民医院自2004年2月至2011年3月收治脑外伤、脑出血致持续昏迷状态患者56例，其中临床判定MCS状态23例，余PVS33例，患者均采用最新的药物、一体化系统综合康复促醒治疗，比较2组患者治疗前、治疗1、3、5个疗程后PVS量表评分和疗效，评定不同年龄段MCS患者疗效的差异。结果治疗3疗程、5疗程后MCS组患者PVS评分均高于PVS组，差异有统计学意义（P〈0．05）。MCS组患者治疗1、3、5疗程后，PVS组患者治疗3、5疗程后PVS评分均高于治疗前，2组患者治疗5疗程后PVS评分均高于治疗1疗程，差异均有统计学意义（P〈0．05）；2组患者疗效的差异有统计学意义（氏0．05），由平均秩次判断，MCS组疗效较好；不同年龄段MCS患者疗效的差异有统计学意义（P〈0．05），其中18～29岁MCS患者疗效最好，〉50岁最差。结论MCS患者的治疗疗效明显好于PVS患者，一体化的系统治疗对于MCS患者很重要，可使多数患者意识恢复。

Objective To investigate the differences in treatment efficacy of patients with minimally conscious state （MCS） and persistent vegetative state （PVS）. Methods Fifty-six continuous coma patients after heavy head injury and severe brain hemorrhage, admitted to our hospital from February 2004 to March 2011, were chosen in our study; 23 of them diagnosed as having MCS, and other 33 as having PVS by internal diagnostic criteria. All patients were treated with new integrative drug treatment and integrative systematical treatment. PVS standard scale was employed to assess the effectiveness before treatment, and 1, 3 and 5 courses after treatment in the 2 groups; and the differences of efficacy in MCS patients of different ages were compared. Results The scores of PVS standard scale in the patients with MCS were significantly higher than those in the patients with PVS at 3 and 5 courses after treatment （P〈0.05）; the scores of PVS standard scale in the patients with MCS at 1, 3 and 5 courses after treatment and patients with PVS 3 and 5 courses after treatment were obviously higher than those before treatment （P〈0.05）; significant difference on the efficacy was noted between the 2 groups （P〈0.05）; and mean rank test indicated that the treatment efficacy in patients with MCS was better than that in patients with PVS. The treatment efficacy in MCS patients of different ages was significantly different （P〈0.05）; patients aged 18-29 enjoyed the best treatment efficacy, while patients aged over 50 enjoyed the worst treatment efficacy. Conclusion The treatment efficacy of patients with MCS is significantly better than that of patients with PVS; integrative systematically therapy is very important for patients with MCS and it can make the majority of patients get recover.