无创神经电刺激对慢性意识障碍患者意识状态水平、全面无反应量表评分的影响

The effect of non-invasive electrical nerve stimulation on the level of consciousness and the score of Full Outline of Unresponsiveness Scale in patients with chronic disturbance of consciousness

目的 探讨无创神经电刺激对慢性意识障碍(pDOC)患者意识状态水平、全面无反应量表(FOUR)评分的影响。方法 我院收治的102例pDOC患者,按照随机数字表法分为研究组和对照组各51例,对照组进行常规治疗,研究组在对照组基础上加以无创神经电刺激治疗。治疗8周后,比较两组患者意识状态格拉斯哥昏迷评分(GCS)、国际昏迷恢复量表(CRS-R)、脑电位、Synck脑电图分级、脑血流量(CBF)、脑血容量(CBV)及FOUR评分。结果 治疗8周后,两组GCS、CRS-R评分均显著升高,且研究组评分高于对照组(P<0.05);两组P300潜伏期均显著缩短,P300波幅均显著升高(P<0.05),两组脑电图分级均显著改善(P<0.05),且研究组改善效果优于对照组(P<0.05);两组CBF、CBV、FOUR评分均显著升高,研究组优于对照组(P<0.05)。结论 无创神经电刺激可显著改善pDOC患者意识状态,加强脑电信号传导和血流灌注,促进患者意识反应恢复。

Objective To explore the effects of non-invasive electrical nerve stimulation on the level of consciousness and the scores of Full Outline of Unresponsiveness(FOUR)in patients with prolonged disorders of consciousness(pDOC).One hundred and two patients with pDOC in our hospital were selected.The patients were divided into a study group and a control group by means of the random number table method,51 in each group.The control group received routine treatment while the study group was additionally given non-invasive electrical nerve stimulation on the basis of the control group.After 8 weeks of treatment,consciousness indexes such as Glasgow Coma Score(GCS),Coma Recovery Scale-Revised(CRS-R),cerebral potential and electroencephalogram grading(Synck electroencephalogram grading),cerebral blood perfusion indexes such as cerebral blood flow(CBF)and cerebral blood volume(CBV)and FOUR scores were compared between the two groups.After 8 weeks of treatment,the scores of GCS and CRS-R in both groups were obviously increased,and the scores in the study group were higher than those in the control group(P<0.05).The P300 latency period in both groups was significantly shortened(P<0.05)and the amplitude of P300 was significantly elevated(P<0.05).The electroencephalogram grading was significantly improved in both groups(P<0.05),and the improvement was more obvious in the study group than that in the control group(P<0.05).The CBF,CBV and FOUR scores were significantly enhanced in both groups(P<0.05),and the above indicators were higher in the study group than those in the control group(P<0.05).Non-invasive electrical nerve stimulation can significantly improve the consciousness of patients with pDOC,enhance the electroencephalogram signal conduction and blood perfusion,and promote the recovery of conscious response.