生物波早期综合治疗联合持续右正中神经刺激疗法对重型颅脑损伤昏迷患者催醒过程的影响

Effect of biological wave early comprehensive rehabilitation therapy combined with continuous right median nerve stimulation therapy on awakening process of coma patients with severe craniocerebral injury

目的探究生物波早期综合治疗联合持续右正中神经刺激疗法对重型颅脑损伤昏迷患者催醒过程的影响。方法选取2021-05—2022-05沧州市人民医院收治的110例重型颅脑损伤昏迷患者,按随机数字表法分成对照组及研究组,每组55例。对照组患者采取持续右正中神经刺激疗法,研究组在对照组的基础上加用生物波早期综合治疗,分析2组患者苏醒状况、血浆脑损伤标志物、脑灌注相关指标、格拉斯哥昏迷量表(GCS)评分、格拉斯哥预后量表(GOS)评分、NIHSS评分及预后。结果与对照组[苏醒率(2周:21.82%;4周:45.45%),苏醒时长(27.39±4.63)d]比较,研究组患者治疗2、4周后苏醒率(2周:54.55%;4周:76.36%)有所上升,苏醒时长[(21.47±3.35)d]有所降低(P<0.05)。治疗后2组患者神经元特异性烯醇化酶(NSE)、血浆人S100B蛋白(S-100B)、髓鞘碱性蛋白(MBP)水平、NIHSS评分下降,脑血容量(CBV)、脑血流量(CBF)及GCS、GOS评分上升,研究组改善程度较对照组高(P<0.05)。研究组临床治疗总有效率(89.09%)高于对照组(70.91%),P<0.05。结论经生物波早期综合治疗联合持续右正中神经刺激疗法可有效降低重型颅脑损伤昏迷患者NSE、S-100B、MBP水平,对改善脑血流灌注发挥了积极的促进作用,加快患者苏醒。

Objective To explore the effect of early comprehensive rehabilitation therapy combined with continuous right median nerve stimulation therapy on the awakening process in coma patients with severe craniocerebral injury.Methods A total of 110 severe craniocerebral injury coma patients admitted to Cangzhou People’s Hospital from May 2021 to May 2022 were selected,and were divided into control group and study group according to the random number table method,with 55 cases in each group.The patients in control group received continuous right median nerve stimulation therapy,and the research group chose to add the early comprehensive rehabilitation treatment of biological wave based on the control group.Recovery status,expression of plasma markers of brain injury,cerebral perfusion related indexes,Glasgow coma scale(GCS)score,Glasgow outcome scale(GOS)score,NIHSS score and prognosis of patients in two groups were analyzed.Results Compared with the control group wake rate(2 weeks:21.82%;4 weeks:45.45%),wake duration(27.39±4.63)d),the wake rate(2 weeks:54.55%,4 weeks:76.36%)increased and wake duration((21.47±3.35)d)decreased(P<0.05).The neuron-specific enolase(NSE),plasma human S100B protein(S-100B),myelin basic protein(MBP)level and the NIHSS score decreased,and cerebral blood volume(CBV),cerebral blood flow(CBF),GCS score and GOS score increased.The improvement degrees of the study group were higher than those of the control group(P<0.05).The overall clinical response rate of the study group(89.09%)was higher than the control group(70.91%),P<0.05.Conclusion Early comprehensive rehabilitation treatment by biological wave combined with continuous right median nerve stimulation therapy can effectively reduce NSE,S-100B and MBP levels in coma patients with severe craniocerebral injury,and play a positive role in improving cerebral blood perfusion in patients and accelerate the recovery.