不同时长正中神经电刺激对意识障碍患者促醒的效果  

Effect of Different Lengths of MNS in Promoting Awakening in Patients with Consciousness Disorders

作　　者：田玲玲 谌秘[2] 邵秀芹[1] 熊淑琴[1] 邹田子 TIAN Ling-ling;SHEN Mi;SHAO Xiu-qin;XIONG Shu-qin;ZOU Tian-zi(Department of Rehabilitation Medicine,the First Affiliated Hospital of Nanchang University,the Fourth Affiliated Hospital of Nanchang University,Nanchang 330006,China;Academic Affairs Office,the Fourth Affiliated Hospital of Nanchang University,Nanchang 330006,China;Department of Nursing,the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]南昌大学第一附属医院康复医学科,南昌330006 [2]南昌大学第四附属医院教务科,南昌330006 [3]西安交通大学第一附属医院护理部,西安710061

出　　处：《实用临床医学（江西）》2024年第2期89-92,107,共5页Practical Clinical Medicine

基　　金：江西省卫健委科技计划项目(202130145)。

摘　　要：目的探讨正中神经电刺激(MNS)对促进意识障碍患者苏醒(促醒)的最佳治疗时长。方法选取2019—2020年收治的意识障碍患者60例,将其按随机数字表法分为对照组(n=30)与观察组(n=30)。2组均在常规康复治疗的基础上加用MNS治疗。观察组和对照组每日MNS时长分别为8、2 h,其频率(50 Hz)、脉宽(300μs)均相同,30 d为一疗程,共治疗3个疗程。治疗前后,均采用格拉斯哥昏迷量表(Glasgow coma scale,GCS)评估患者意识障碍的严重程度,采用修订版昏迷恢复量表(coma recovery scale-revised,CRS-R)评估昏迷后意识障碍程度;另记录2组治疗后的昏迷时长。结果相较治疗前,2组患者治疗后的GCS和CRS-R评分更高、CRS-R等级更优(P<0.001);且治疗后观察组GCS和CRS-R评分高于对照组,CRS-R等级优于对照组(P<0.05)。观察组昏迷时长短于对照组[(26.80±8.39)d比(22.10±4.72)d,t=-2.67、P<0.05]。结论MNS治疗时长设置为8 h时促醒效果更为明显。Objective To investigate the optimal treatment duration of median nerve stimulation(MNS)for promoting awakening(pro-arousal)in patients with consciousness disorders.Methods 60 patients with consciousness disorders admitted to our hospital from 2019 to 2020 were randomly divided into the control group(n=30)and the experimental group(n=30).Both groups were treated with MNS on the basis of conventional awakening methods.The daily duration of MNS in the experimental group and the control group was 8 and 2 h,respectively,with the same frequency(50 Hz)and pulse width(300μs),and 30 d was a course of treatment,with a total of 3 courses of treatment.Before and after treatment,the severity of the patients’impaired consciousness was assessed using the Glasgow coma scale(GCS),and the degree of impaired consciousness after coma was assessed using the coma recovery scale-revised(CRS-R);the length of coma after treatment was also recorded in the 2 groups.Results Compared with the pre-treatment,the patients in the 2 groups had higher GCS and CRS-R scores and better CRS-R grades after treatment(P<0.001);and the GCS and CRS-R scores in the experimental group were higher than those in the control group,and the CRS-R grades were better than those in the control group after treatment(P<0.05).The length of coma in the experimental group was shorter than that in the control group[(26.80±8.39)d vs(22.10±4.72)d,t=-2.67,P<0.05].Conclusion Our findings suggest that electrical stimulation of median nerve for 8 hours can effectively promote the recovery of patients with consciousness disorders.

关 键 词：意识障碍 正中神经电刺激 昏迷时长 促进意识障碍患者苏醒 康复 

分 类 号：R473.5[医药卫生—护理学]