正中神经电刺激对脑损伤后昏迷患者血流动力学的影响

Effect of Median Nerve Electrical Stimulation on Hemodynamics in Severe Brain Injury Patients with Coma

目的探讨正中神经电刺激疗法对重型颅脑损伤后昏迷患者的疗效及脑血流动力学影响。方法选取2016年1月~2016年12月淮安市第一人民医院神经外科收治的112例重型颅脑损伤后昏迷患者,随机分为实验组、对照组,每组各56例,均接受基础治疗,实验组在术后1周接受正中神经电刺激治疗。结果 2个组别治疗及随访期间无死亡病例。治疗前,2个组别的大脑中动脉血流动力学、格拉斯哥昏迷评分(GCS)和神经功能障碍评分(DRS)及听觉脑干诱发电位差异无统计学意义(均P>0.05)。治疗后及随访2个月,2个组别的血流速度(Vs)、平均血流速度(Vm)和GCS评分显著增高(均P<0.05),搏动指数(PI)、DRS评分和听觉脑干诱发电位显著降低(均P<0.05)。治疗后,与对照组比,实验组的Vs、Vm和GCS评分显著增高(均P<0.05),PI、DRS评分和听觉脑干诱发电位显著降低(均P<0.05);随访2个月,2个组别的大脑中动脉血流动力学、GCS和DRS评分及听觉脑干诱发电位差异无统计学意义(均P>0.05)。结论重型颅脑损伤后昏迷患者采用正中神经电刺激对患者苏醒及脑血流动力学均具有显著的改善作用。

Objective To investigate the effect of median nerve electrical stimulation on the severe brain injury patients with coma.Methods From January 2016 to December 2016,112 cases of severe craniocerebral injury patients with coma in our hospital were divided into experimental group and control group（56cases in each group）.Both groups received basic treatment.In addition,the experimental group was given median nerve electrical stimulation based on the basic treatment.ResultsThere were no death cases in both groups.Before treatment,the Vs,Vm,PI,Glasgow Coma Scale（GCS）score,DRS score and auditory brainstem evoked potential were not significantly different between the two groups（all P0.05）.After treatment and2-month follow-up,the Vs,Vm and GCS score were increased,while PI,DRS and auditory brainstem evoked potential were decreased in both groups（all P0.05）.After treatment,compared with the control group,the Vs,Vm and GCS were increased,PI,DRS and auditory brainstem evoked potential decreased in the experimental group（all P0.05）.After 2-month follow-up,there were no significant differences in the Vs,Vm,PI and GCS score,DRS score and auditory brainstem evoked potential between the two groups（all P0.05）.Conclusion The median nerve electrical stimulation can significantly promote recovery and improve cerebral hemodynamics in severe craniocerebral injury patients with coma.