三维五感促醒联合正中神经电刺激在重型颅脑损伤患者中的应用  

Application of three-dimensional five-sense awakening therapy combined with median nerve electrical stimulation to severe craniocerebral injury

作　　者：李焕杰 周该该 程慧芳 LI Huan-jie;ZHOU Gai-gai;CHENG Hui-fang

机构地区：[1]郑州市第三人民医院神经外科,河南郑州450000

出　　处：《中国疗养医学》2025年第4期36-39,共4页Chinese Journal of Convalescent Medicine

摘　　要：目的 探讨三维五感促醒联合正中神经电刺激在重型颅脑损伤患者中的应用。方法 选取2021年8月至2023年8月郑州市第三人民医院神经外科收治的96例重型颅脑损伤意识障碍患者,采用抽签法将其分为对照组(48例)和研究组(48例)。给予对照组正中神经电刺激,研究组在此基础上增加三维五感促醒疗法。经过6个月治疗,对比两组苏醒情况[改良昏迷恢复量表(CRS-R)]、昏迷程度[格拉斯哥昏迷量表(GCS)]、神经功能障碍[残疾评分量表(DRS)]神经电生理变化[脑干听觉诱发电位(BAEP)、体感诱发电位(SEP)、脑电图(EEG)]、脑血流动力学指标[大脑动脉收缩期血流流动速度(VS)、平均血流速度(VM)、搏动指数(PI)]以及神经功能障碍。结果 治疗后,研究组CRS-R(15.67±2.13)分、GCS(12.67±1.43)分以及DRS(14.98±2.52)分高于对照组CRS-R(11.88±2.12)分、GCS(9.88±1.12)分和DRS(11.67±2.63)分(P<0.05);研究组BAEP(1.43±0.19)分、SEP(1.48±0.23)分、EEG(1.64±0.33)分显著低于对照组BAEP(1.88±0.54)分、SEP(1.79±0.25)分和EEG(2.99±0.89)分(P<0.05);研究组VS、VM比对照组高,且PI低于对照组(P<0.05)。结论 重型颅脑损伤意识障碍患者采取三维五感促醒疗法联合正中神经电刺激治疗,可以促进患者苏醒,降低昏迷的严重程度,改善神经电生理变化和脑血流量,提高神经功能。Objective To explore the application of three-dimensional five-sense awakening therapy combined with median nerve electrical stimulation to severe craniocerebral injury.Methods A total of 96 patients with consciousness disorder following severe craniocerebral injuries were selected from the Department of Neurosurgery of the Third People's Hospital of Zhengzhou from August 2021 to August 2023.They were divided into the control group(48 cases)and study group(48 cases)by drawing lots.The control group was given median nerve electrical stimulation,and the study group was given the three-dimensional five-sense awakening therapy combined with median nerve electrical stimulation.After six months of treatment,the recovery status(the modified coma recovery scale[CRS-R]),coma degree(the Glasgow coma scale[GCS]),the disability rating scale(DRS),neuroelectrophysiological changes(brainstem auditory evoked potential[BAEP],somatosensory evoked potential[SEP],electroencephalogram[EEG]),cerebral hemodynamic parameters(cerebral arterial systolic blood flow velocity[VS],mean blood flow velocity[VM],pulse index[PI])and neurological dysfunction were compared.Results After treatment,the CRS-R([15.67±2.13]points VS[11.88±2.12]points),GCS([12.67±1.43]points VS[9.88±1.12]points)and DRS([14.98±2.52]points VS[11.67±2.63]points)scores of the study group were significantly higher than those of the control group(P<0.05).The BAEP([1.43±0.19]VS[1.88±0.54]),SEP([1.48±0.23]VS[1.79±0.25])and EEG([1.64±0.33]VS[2.99±0.89])in the study group were significantly lower than those of the control group(P<0.05).VS and VM in the study group were significantly higher than those of the control group,and PI was significantly lower than that in the control group(P<0.05).Conclusion Three-dimensional five-sense awakening therapy combined with median nerve electrical stimulation can promote recovery,reduce the severity of coma,improve nerve electrophysiological changes and cerebral blood flow,and improve nerve function in patients with severe craniocer

关 键 词：三维五感促醒疗法 正中神经电刺激 重型颅脑损伤 意识障碍 脑血流动力 

分 类 号：R651.1[医药卫生—外科学]