脑损伤昏迷患者促醒治疗的进展

Progress in wake promoting treatment for patients with brain injury and coma

脑损伤后昏迷是常见的神经外科急危重症,昏迷患者的中枢神经系统在早期受损阶段,其结构与功能上有较大的可塑性,部分细胞功能经过治疗可得到一定的恢复,从而降低其致残率及死亡率,减轻医疗经济负担。随着临床科研、技术工作的全面快速进展,人们对脑损伤昏迷患者的促醒治疗研究在不断深入,早期手术、防治严重并发症、使用促醒药物、亚低温、中医针刺、神经电刺激、感觉刺激、高压氧等均在临床上取得一定的促醒治疗效果。本文通过对促醒治疗的作用与方法以及评价观察指标、量表等进行综述,为相关临床工作提供参考。

Coma after brain injury is a common neurosurgical critical illness.In the early stage of damage,the central nervous system of comatose patients has great plasticity in structure and function,and some of the cell functions can be restored after treatment,thus reducing its disability and mortality and reducing the medical economic burden.With the overall and rapid progress of clinical research and technical work,the research on the wake promoting treatment of patients with brain injury and coma is deepening.Early surgery,prevention and treatment of serious complications,use of wake promoting drugs,mild hypothermia,acupuncture of Chinese medicine,nerve electrical stimulation,sensory stimulation,hyperbaric oxygen,etc.have achieved a certain degree of clinical wake promoting treatment.This article reviews the effects and methods of wake promoting treatment,evaluation indicators andscales,etc.,to provide reference for relevant clinical work.