正中神经功能性磁刺激对慢性意识障碍的临床疗效观察

Efficacy of median nerve functional magnetic stimulation in patients with prolonged disorders of consciousness

目的探讨正中神经功能性磁刺激(FMS)治疗对慢性意识障碍(pDoC)的临床疗效。方法选取2019年1月至2022年8月绍兴市人民医院康复医学科收治的pDoC患者60例为研究对象。采用随机数字表法将患者分为观察组30例和对照组30例,两组患者均接受常规促醒治疗,观察组患者在此基础上增加正中神经FMS治疗。分别于治疗前及治疗6周后行改良昏迷恢复量表(CRS-R)评分评定及脑电图检测,并根据CRS-R评分评估患者的意识转归情况。结果治疗6周后,两组患者CRS-R评分均高于治疗前,且观察组患者CRS-R评分高于对照组,差异均有统计学意义(均P<0.01)。观察组患者脑电图有改善率为26.7%,明显高于对照组的6.7%,差异有统计学意义(P<0.05)。进一步分析,观察组患者意识好转率为56.7%,明显高于对照组的23.3%,差异有统计学意义(P<0.05)。结论采用正中神经FMS治疗对促醒pDoC患者有效。

Objective To investigate the clinical efficacy of median nerve functional magnetic stimulation(FMS)therapy in patients with prolonged disorders of consciousness(pDoC).Methods Sixty patients with pDoC admitted to the Department of Rehabilitation of Shaoxing People's Hospital from January 2019 to August 2022 were randomly divided into study group(30 cases)and control group(30 cases).Both groups received conventional awakening therapy,while additional median nerve FMS therapy was given to the study group.Coma recovery scale-revision(CRS-R)score assessment and EEG examination were performed before and 6 weeks after treatment.Results After 6 weeks of treatment,the CRS-R scores of 2 groups were increased compared to those before treatment,and the CRS-R score in the study group was higher than that of control group(all P<0.01).The improvement rate of EEG in study group was 26.7%,which was significantly higher than that in the control group(6.7%,P<0.05).Further analysis showed that the improvement rate of consciousness in the study group was 56.7%,significantly higher than that in the control group(23.3%,P<0.05).Conclusion Median nerve FMS therapy is beneficial to pDoC patients.