文章摘要
黄寒冰,夏楠,周志忠,柯俊,黄杰.标准化体位变换联合前庭刺激对严重意识障碍的促醒作用[J].中国康复,2018,33(5):385-388
标准化体位变换联合前庭刺激对严重意识障碍的促醒作用
The awakening effect of standardized body position transformation combined with vestibular nerve stimulation program on patients with severe disturbance of consciousness
  
DOI:
中文关键词: 意识障碍  促醒  标准化体位变换  前庭刺激
英文关键词: consciousness disorder  wakefulness  standardized body position transformation  vestibular stimulation
基金项目:
作者单位
黄寒冰 华中科技大学同济医学院附属同济医院康复医学科武汉 430030 
夏楠 华中科技大学同济医学院附属同济医院康复医学科武汉 430030 
周志忠 华中科技大学同济医学院附属同济医院康复医学科武汉 430030 
柯俊 华中科技大学同济医学院附属同济医院康复医学科武汉 430030 
黄杰 华中科技大学同济医学院附属同济医院康复医学科武汉 430030 
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中文摘要:
      目的: 探讨标准化体位变换联合前庭神经刺激方案对重型颅脑损伤后严重意识障碍患者的促醒效果。方法: 入选20例重型颅脑损伤后严重意识障碍患者, 随机分入观察组与对照组各10例。2组患者均接受常规康复治疗,观察组在常规康复治疗基础上增加标准化的体位变换联合前庭神经刺激治疗方案进行治疗,使用脑电图(EEG)改良分级标准对治疗前、治疗2个月后患者脑电状态进行评估,同时使用昏迷恢复量表(CRS-R)分别于治疗前、治疗2个月后以及治疗后3个月随访对患者的意识状态进行评估,对比分析2组患者的脑功能改善情况。结果: 治疗2个月后及3个月随访,2组CRS-R评分均较治疗前显著提高(P<0.01,0.05);治疗2个月后,观察组CRS-R评分更高于对照组(P<0.05),治疗后3个月随访,CRS-R评分组间差异无统计学意义。治疗2个月后,2组EEG分级均较治疗前显著改善(P<0.05),但组间对比未见显著差异(P>0.05)。结论: 标准化体位变换联合前庭刺激治疗作为一种强化的专项治疗,能够更有效改善严重意识障碍患者的脑功能,是一种较好的颅脑损伤后意识障碍患者的促醒治疗方法。
英文摘要:
      Objective: To explore the awakening effect of standardized body position transformation combined with vestibular nerve stimulation program on patients with severe disturbance of consciousness after craniocerebral injury. Methods: All 20 patients with severe conscious disturbance after craniocerebral injury were involved and randomly divided into study group (n=10) and control group (n=10). Both groups received conventional rehabilitation according to the routine procedure. The study group received additional standardized positional changes combined with vestibular nerve stimulation treatment. The modified grades standard of electroencephalogram (EEG) was used to assess the brain electrical status of patients before and after 2-month awakening treatment, and the Coma Recovery Scale-Revised (CRS-R) was used before, after treatment of two months and three months after treatment to evaluate the consciousness state. The brain function of subjects was compared and analyzed between study group and control group. Results: The CRS-R scores in the two groups were significantly increased after 2 months of treatment (P<0.01, 0.05); After 2 months, the CRS-R scores in study group were significantly higher than in control group (P<0.05). No significant difference was detected between the two groups in the CRS-R assessment after treatment for 3 months. After treatment for 2 months, the EEG grades showed significant improvement in both groups as compared with those before treatment (P<0.05). No difference of EEG grades was detected between two groups after the treatment (P>0.05). Conclusion: Standardized positional transformation combined with vestibular stimulation therapy as an intensive special treatment can improve the brain function of patients with severe disturbance of consciousness more effectively. It is a relatively good awakening method for disturbance of consciousness after craniocerebral injury.
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