正中神经电刺激对重症颅脑损伤昏迷病人脑血流速度及脑血流量的影响  

Effects of Median Nerve Electrical Stimulation on Cerebral Blood Flow Velocity and Cerebral Blood Flow in Patients with Coma after Severe Craniocerebral Injury

作　　者：王振宁[1] 叶嘉文 罗灼明 朱灼坤 江耿思[1] 陈桂增[1] 刘小红[1] WANG Zhenning;YE Jiawen;LUO Zhuoming;ZHU Zhuokun;JIANG Gengsi;CHEN Guizeng;LIU Xiaohong(Dongguan People′s Hospital,Dongguan 523059,Guangdong,China)

机构地区：[1]东莞市人民医院,广东东莞523059

出　　处：《中西医结合心脑血管病杂志》2019年第9期1406-1410,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：东莞市社会科技发展(一般)项目(No.2018507150011345)

摘　　要：目的探讨正中神经电刺激对重症颅脑损伤昏迷病人脑血流速度及脑血流量的影响。方法将2017年7月—2018年8月我院收治的62例重症颅脑损伤昏迷病人随机分为两组,各31例,对照组采用亚低温、高压氧、康复疗法及其他物理疗法;在此基础上,观察组采用正中神经电刺激治疗,持续治疗4周。比较两组病人的临床疗效、大脑中动脉平均血流速度(Vm)、局部脑血流量(rCBF)、局部脑血容量(rCBV)及格拉斯哥昏迷量表(GCS)评分、残疾程度评分(DRS),记录不良反应。结果观察组临床疗效总有效率为83.87%,高于对照组的61.29%,差异有统计学意义(P<0.05)。治疗后对照组和观察组大脑中动脉Vm分别为(51.17±5.64)cm/s、(55.81±5.37)cm/s,rCBF分别为(37.86±11.15)mL/(100 g·min)、(44.10±13.28)mL/(100 g·min),rCBV分别为(2.29±0.53)mL/100 g、(3.10±0.62)mL/100 g,GCS评分分别为(9.03±1.68)分、(10.34±1.45)分,DRS评分分别为(8.29±3.10)分、(6.53±2.57)分,观察组大脑中动脉Vm、rCBF、rCBV、GCS评分高于对照组,DRS评分低于对照组,差异均有统计学意义(P<0.05)。两组病人不良反应率比较差异无统计学意义(P>0.05)。结论正中神经电刺激有助于提高重症颅脑损伤昏迷病人的脑血流速度和脑血流量,改善昏迷症状,提高临床疗效。Objective To investigate the effects of median nerve electrical stimulation on cerebral blood flow velocity and cerebral blood flow volnme in patients with coma after severe craniocerebral injury.Methods Sixty-two patients with coma after severe craniocerebral injury in our hospital from July 2017 to August 2018 were randomly divided into two groups:control group(n=31)treated with routine treatment such as mild hypothermia,hyperbaric oxygen,rehabilitation therapy and other physical therapy,and observation group(n=31)treated with median nerve electrical stimulation plus routine treatment for 4 weeks.The clinical efficacy,mean middle cerebral blood flow velocity(Vm),regional cerebral blood flow(rCBF),regional cerebral blood volume(rCBV),Glasgow Coma Scale(GCS)score,and Disability Rating Scale(DRS)score were compared between the two groups.The adverse reactions were observed.Results The total clinical effective rate was 83.87%in observation group,which was significantly higher than that in control group(61.29%,P<0.05).After treatment,Vm was(51.17±5.64)cm/s in the control group and(55.81±5.37)cm/s in the observation group,respectively.The rCBF was(37.86±11.15)mL/(100 g·min)in the control group and(44.10±13.28)mL/(100 g·min)in the observation group,respectively.The rCBV was(2.29±0.53)mL/100 g in the control group and(3.10±0.62)mL/100 g in the observation group,respectively.The GCS scores were(9.03±1.68)in the control group and(10.34±1.45)in the observation group,respectively.The DRS scores were(8.29±3.10)in the control group and(6.53±2.57)in the observation group,respectively.The Vm,rCBF,rCBV,and GCS scores were higher in the observation group than those in the control group(P<0.05),while the DRS score was lower in the observation group than that in the control group(P<0.05).There was no significant difference in the adverse reaction rate between the two groups(P>0.05).Conclusion Median nerve electrical stimulation can improve the cerebral blood flow velocity and cerebral blood flow volnme,improve coma sym

关 键 词：重症颅脑损伤 昏迷 正中神经电刺激 脑血流速度 脑血流量 

分 类 号：R651[医药卫生—外科学] R269[医药卫生—临床医学]