正中神经电刺激对脑损伤后昏迷患者脑血流速度及神经电生理的影响
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[摘要] 目的：研究正中神经电刺激对脑损伤后昏迷患者脑血流速度及神经电生理的影响，以探索其可能的促醒机制。方法：将30例脑损伤后昏迷患者随机分为治疗组(n=15)和对照组(n=15)，两组均给予常规促苏醒治疗，治疗组在常规治疗的基础上加用正中神经电刺激治疗，两组治疗前后均行脑电图、脑干听觉诱发电位检查，同时行经颅多普勒脑血管超声检测患者大脑中动脉、基底动脉平均血流速度。治疗后行GCS昏迷评分进行疗效评定。结果：治疗1个月后，治疗组大脑中动脉及基底动脉平均血流速度分别为(93.50±9.67)与(37.15±5.36)cm/s，较对照组明显加快(P<0.05)。治疗后治疗组脑电图慢波减少，出现α节律，脑干听诱发提示Ⅰ～Ⅴ、Ⅲ～Ⅴ波间潜伏期差缩短，Ⅲ、Ⅴ波波幅增高。治疗1个月后治疗组GCS评分平均提高4.38分，对照组平均提高2.06分，两组比较，差异有统计学意义(P<0.05)。结论：正中神经电刺激能提高脑损伤后昏迷患者的脑血流速度，改善脑电活动，对昏迷患者有较好的促醒作用。
[关键词] 正中神经；电刺激；脑血流速度；神经电生理；昏迷；脑损伤
[中图分类号] R651.1[文献标识码]A [文章编号]1673-7210(2011)03(c)-023-04
Effect on cerebral blood flow velocity and electroneurophysiology in comatose patients with brain injury after mediam nerve electrical stimulation
XIE Ying, YOU Xin, CHEN Yan, JIANG Yan, HU Yue
Neuro-Rehabilitation Center in Beijing Electric Power Hospital, Beijing 100073, China
[Abstract] Objective: To investigate the therapeutic effect on cerebral blood flow velocity and electroneurophysiology in comatose patients with brain injury after mediam nerve electrical stimulation，and to explore the possible mechanism of its′ hastening awakening from coma. Methods: 30 unconscious patients with brain injury were randomly assigned to the treatment group (n=15) and control group (n=15), the patients in the control group were treated routinely. Besides routine therapy the patients in the treatment group were treated with median nerve electrical stimulation. Electroencephalography (EEG) and brain stem auditory evoked potential (BAEP) were determinated before and after treatment, at the same time, mean flow rates of middle cerebral artery (MCA) and basilar artery (BA) were determinated with transcranial Doppler (TCD),Glasgow scale (GCS) was used to evaluate the curative effect after treatment. Results: After one-month treatment, the mean flow rates of middle cerebral artery and basilar artery in the treatment group were (93.50±9.67) and (37.15±5.36) cm/s，which were faster than that of the control group (P<0.05). Test results showed improvement both in EEG and in BAEP, after treatment, the GCS score in treatment group was increased than that of the control group (P<0 ......
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