文章摘要
于利国,孙瑞,马艳,刘金明,王博,章志超.高压氧联合正中神经电刺激对植物状态患者的促醒疗效观察[J].中国康复,2024,39(6):350-353
高压氧联合正中神经电刺激对植物状态患者的促醒疗效观察
Efficacy of hyperbaric oxygen combined with median nerve electrical stimulation in promoting awakening in patients with vegetative state
  
DOI:
中文关键词: 正中神经电刺激  高压氧  植物状态  促醒
英文关键词: median nerve electrical stimulation  hyperbaric oxygen  vegetative state  wakefulness promotion
基金项目:武汉市卫健委医学科研项目(WX21Q19)
作者单位
于利国 武汉市第一医院康复医学中心武汉 430000 
孙瑞 武汉市第一医院康复医学中心武汉 430000 
马艳 武汉市第一医院康复医学中心武汉 430000 
刘金明 武汉市第一医院康复医学中心武汉 430000 
王博 武汉市第一医院康复医学中心武汉 430000 
章志超 武汉市第一医院康复医学中心武汉 430000 
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中文摘要:
  目的:探索高压氧联合正中神经电刺激对植物状态患者的促醒疗效。方法:共纳入60例植物状态患者,随机分为对照组和观察组各30例。2组患者均接受正中神经电刺激,观察组加用高压氧治疗,对照组给与常规氧疗。治疗前后,分别记录2组患者的苏醒率,评估2组患者修订昏迷恢复量表(CRS-R)、全面无反应评分量表(FOUR)、脑电图(EEG)及扩展格拉斯哥结局量表(GOS-E)。结果:治疗4周后,对照组有8例(26.7%)患者CRS-R达到最小意识状态,观察组患者有13例(43.3%)患者CRS-R达到最小意识状态。2组苏醒率比较差异无统计学意义(χ2=1.832,P=0.176)。治疗后,2组患者CRS-R评分、FOUR评分EEG分级均较治疗前明显升高(P<0.01),且观察组均高于对照组(P<0.01)。治疗后,2组患者GOS-E评分均较治疗前明显升高(P<0.01),但2组间比较差异无统计学意义。结论:高压氧联合正中神经电刺激可以改善植物状态患者的意识水平及预后。
英文摘要:
  Objective: To explore the efficacy of hyperbaric oxygen combined with electrical stimulation of the median nerve in promoting awakening of patients in vegetative state. Methods: A total of 60 patients with vegetative state were randomly divided into 30 patients in the control group and 30 patients in the observation group, and both groups received median nerve electrical stimulation, with hyperbaric oxygen therapy in the observation group and conventional oxygen therapy in the control group. Before and after the treatment, the awakening rates of the two groups were recorded, and the patients in the two groups were evaluated with the Revised Coma Recovery Scale (CRS-R), the Fully Unresponsive Rating Scale (FOUR), the electroencephalogram (EEG), and the Expanded Glasgow Outcome Scale (GOS-E), respectively. Results: After 4 weeks of treatment, 8 (26.7%) patients in the control group and 13 (43.3%) patients in the observation group achieved minimal consciousness on CRS-R. The difference in the awakening rate between the 2 groups was not statistically significant (χ2=1.832, P=0.176). After treatment, the CRS-R score and FOUR score EEG grading in the 2 groups were significantly higher than before treatment (P<0.01), and those in the observation group were higher than the control group (P<0.01). After treatment, the GOS-E scores in both groups were significantly higher than before treatment (P<0.01), but the difference between the 2 groups was not statistically significant. Conclusion: Hyperbaric oxygen combined with median nerve electrical stimulation can improve the level of consciousness and prognosis of patients in vegetative state.
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