三叉神经电刺激对获得性脑损伤继发性昏迷的促醒作用:一项回顾性病例对照研究

Wake-promoting Effect of Trigeminal Nerve Electrical Stimulation on Coma Secondary to Acquired Brain Injury:A Retrospective Case-control Study

目的:评估三叉神经电刺激(TNS)疗法对获得性脑损伤继发性昏迷患者的临床疗效。方法:回顾性分析2015年1月-2019年12月我院康复医学科住院昏迷患者的临床资料。比较采用TNS治疗的观察组与常规康复治疗的对照组治疗前、治疗后4周的格拉斯哥昏迷评分(GCS)。结果:治疗后两组患者意识状态均有所改善,GCS评分与治疗前均明显增加(P<0.05),且观察组的意识改善明显优于对照组(P<0.05)。此外,TNS对脑外伤、缺血性脑卒中和缺血缺氧性脑病后昏迷的患者促醒效果明显(P<0.05),且在病程的不同阶段均有较好的促醒作用,尤其是亚急性期(P<0.01)。结论:三叉神经电刺激可改善昏迷患者的意识水平,建议纳入昏迷患者的整体治疗体系中。

Objective:To evaluate the efficacy of trigeminal nerve electrical stimulation(TNS)to treat patients with coma secondary to acquired brain injury.Methods:The clinical data of patients with coma were retrospectively analyzed from Jan 2015 to Dec 2019.The Glasgow Coma Scale(GCS)was compared before and 4 weeks after treatment between the observation group and control group to assess patients.level of consciousness.Results:The GCS scores increased and the consciousness state improved in both groups of patients after 4 weeks of treatment(P<0.05).However,compared with control group,the degrees of changes in GCS was larger in the observation group(P<0.05).Furthermore,TNS had significant arousal effect on patients experienced traumatic brain injury,ischaemic stroke or hypoxic-ischemic encephalopathy(P<0.05).TNS had good effect in different stage of the disease course,especially in the subacute stage(P<0.01).Conclusion:TNS can improve the consciousness of patients with coma,and we suggest that it could be integrated into the overall management of coma.