[1]罗 兰,熊 莉.高压氧联合正中神经电刺激治疗对重型颅脑损伤患者脑血流动力学、意识状态及颅多普勒参数的影响[J].陕西医学杂志,2023,52(12):1702-1706.[doi:DOI:10.3969/j.issn.1000-7377.2023.12.016]
　LUO Lan,XIONG Li.Effects of hyperbaric oxygen combined with median nerve electrical stimulation on cerebral hemodynamic,consciousness state and transcranial Doppler parameters in patients with severe craniocerebral injury[J].,2023,52(12):1702-1706.[doi:DOI:10.3969/j.issn.1000-7377.2023.12.016]
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高压氧联合正中神经电刺激治疗对重型颅脑损伤患者脑血流动力学、意识状态及颅多普勒参数的影响
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年12期
页码:
1702-1706
栏目:
临床研究
出版日期:
2023-12-05

文章信息/Info

Title:
Effects of hyperbaric oxygen combined with median nerve electrical stimulation on cerebral hemodynamic,consciousness state and transcranial Doppler parameters in patients with severe craniocerebral injury
作者:
罗 兰; 熊 莉
(电子科技大学医学院附属绵阳医院 绵阳市中心医院急诊医学科,四川 绵阳 621000)
Author(s):
LUO Lan; XIONG Li
(Department of Emergency Medicine,Mianyang Hospital Affiliated to Medical School of University of Electronic Science and Technology of China,Mianyang 621000,China)
关键词:
重型颅脑损伤;  高压氧;  正中神经电刺激;  脑血流动力学;  意识状态;  经颅多普勒参数
Keywords:
Severe craniocerebral injury;  Hyperbaric oxygen;  Median nerve electrical stimulation;  Cerebral hemodynamics;  Consciousness state;  Transcranial Doppler parameters
分类号:
R 651.15
DOI:
DOI:10.3969/j.issn.1000-7377.2023.12.016
文献标志码:
A
摘要:
目的:观察高压氧(HBO)联合正中神经电刺激(MNES)治疗对重型颅脑损伤患者脑血流动力学、意识状态及经颅多普勒(TCD)参数的影响。方法:选取重型颅脑损伤患者106例,按照入院先后顺序分为HBO组(53例,采取常规对症及HBO治疗)和MNES组(53例,在HBO组基础上联合MNES治疗)。比较两组患者临床疗效、治疗前后脑血流动力学指标[脑血容量(CBV)和脑血流量(CBF)]、意识状态评估指标[神经功能缺损量表(ESS)、格拉斯哥昏迷评分量表(GCS)、格拉斯哥预后量表(GOS)]、TCD参数[动脉平均血流速度(Vm)、阻力指数(RI)及搏动指数(PI)]、脑氧代谢指标[脑氧摄取率(CERO2)、脑动静脉血氧含量差(Da-jvO2)、颈静脉血氧饱和度(SjvO2)和血氧饱和度(SpO2)],记录两组不良反应的发生情况。结果:MNES组治疗有效率高于HBO组(P<0.05)。治疗后,两组CBV、CBF、ESS、GCS以及GOS较治疗前升高,且MNES组高于HBO组(均P<0.05); 两组Vm、RI以及PI较治疗前降低,且MNES组低于HBO组(均P<0.05); 两组ERO2和SjvO2较治疗前降低,Da-jvO2和SpO2较治疗前升高,且MNES组ERO2和SjvO2低于HBO组,Da-jvO2和SpO2高于HBO组(均P<0.05)。结论:高压氧联合正中神经电刺激治疗能够有效地改善重型颅脑损伤患者的脑血流动力学,促进患者意识功能的恢复,调节患者脑氧代谢。
Abstract:
Objective:To observe the effects of hyperbaric oxygen(HBO)combined with median nerve electrical stimulation(MNES)therapy on cerebral hemodynamic,consciousness state and transcranial Doppler(TCD)parameters in patients with severe craniocerebral injury.Methods:A total of 106 patients with severe craniocerebral injury were selected and divided into HBO group(53 cases,treated with routine symptomatic treatment and HBO)and MNES group(53 cases,treated with HBO combined with MNES)according to the order of admission.The clinical efficacy,cerebral hemodynamics indexes(cerebral blood volume [CBV] and cerebral blood flow [CBF] ),consciousness state evaluation indexes(Neurological Deficit Scale [ESS],Glasgow Coma Scale [GCS],Glasgow Outcome Scale [GOS] ),and TCD parameters(mean arterial blood flow velocity [Vm] and Resistance Index [RI] and Pulsatility Index [PI] )and cerebral oxygen metabolism indexes(cerebral oxygen extraction rate [CERO2],cerebral arteriovenous oxygen content difference [Da-jvO2],jugular venous oxygen saturation [SjvO2] and blood oxygen saturation [SpO2])before and after treatment were compared between the two groups,and adverse reactions of the two groups were recorded.Results:The effective rate in MNES group was significantly higher than that in HBO group(P<0.05).After treatment,CBV,CBF,ESS,GCS and GOS in the two groups were higher than those before treatment,and those in the MNES group were higher than those in the HBO group(all P<0.05); Vm,RI and PI in the two groups were lower than those before treatment,and those in the MNES group were lower than those in the HBO group(all P<0.05); in two groups,ERO2 and SjvO2 were decreased than those before treatment,Da-jvO2 and SpO2 were increased than those before treatment,and ERO2 and SjvO2 in the MNES group were lower than those in the HBO group,Da-jvO2 and SpO2 were higher than those in the HBO group(all P<0.05).Conclusion:Hyperbaric oxygen combined with median nerve stimulation therapy can effectively improve the cerebral hemodynamic state of patients with severe craniocerebral injury,promote the recovery of consciousness function,and regulate cerebral oxygen metabolism.

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备注/Memo

备注/Memo:
基金项目:四川省基层卫生事业发展研究中心项目(SWFZ19-Z-58)
更新日期/Last Update: 2023-12-05