[1]杜延平,梁建广,王玉海,等.基于常规治疗基础的右正中神经刺激对重型颅脑损伤患者SPECT/CT、脑血流动力学及脑电图synek分级的影响[J].中国医学物理学杂志,2023,40(11):1423-1427.[doi:DOI:10.3969/j.issn.1005-202X.2023.11.017]
　DU Yanping,LIANG Jianguang,WANG Yuhai,et al.Effects of right median nerve stimulation combined with conventional treatment on SPECT/CT, cerebral hemodynamics and EEG synek grading in patients with severe traumatic brain injury[J].Chinese Journal of Medical Physics,2023,40(11):1423-1427.[doi:DOI:10.3969/j.issn.1005-202X.2023.11.017]
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基于常规治疗基础的右正中神经刺激对重型颅脑损伤患者SPECT/CT、脑血流动力学及脑电图synek分级的影响()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
40卷
期数:
2023年第11期
页码:
1423-1427
栏目:
医学生物物理
出版日期:
2023-11-24

文章信息/Info

Title:
Effects of right median nerve stimulation combined with conventional treatment on SPECT/CT, cerebral hemodynamics and EEG synek grading in patients with severe traumatic brain injury
文章编号:
1005-202X（2023）11-1423-05
作者:
杜延平1; 梁建广1; 王玉海2; 张夏慧1; 金东1; 姜立先1
1.无锡市中医医院（南京中医药大学附属无锡医院）神经外科， 江苏 无锡 214001； 2.联勤保障部队第九0四医院神经外科， 江苏 无锡 214044
Author(s):
DU Yanping1;  LIANG Jianguang1;  WANG Yuhai2;  ZHANG Xiahui1;  JIN Dong1;  JIANG Lixian1
1. Department of Neurosurgery, Traditional Chinese Medicine Hospital of Wuxi (Wuxi Hospital Affiliated to Nanjing University of Chinese Medicine), Wuxi 214001, China 2. Department of Neurosurgery, No.904 Hospital of the Joint Logistics Support Force of the Peoples Liberation Army of China, Wuxi 214044, China
关键词:
重型颅脑损伤; 右正中神经刺激疗法; 单光子发射计算机断层成像技术; 血流动力学; 脑电图
Keywords:
Keywords: severe traumatic brain injury right median nerve stimulation therapy single-photon emission computed tomography hemodynamics electroencephalogram
分类号:
R651.1；R816.1
DOI:
DOI:10.3969/j.issn.1005-202X.2023.11.017
文献标志码:
A
摘要:
目的：分析基于常规治疗基础的右正中神经刺激疗法在重型颅脑损伤（sTBI）患者中的应用效果。方法：选取60例sTBI患者，均处于昏迷状态，格拉斯哥昏迷评分低于9分。患者经随机数字表法被分成观察组（n=30）和对照组（n=30），其中对照组接受常规疗法，观察组在此基础上接受右正中神经刺激疗法，治疗周期均为1个月。比较两组治疗效果、脑血流动力学水平、脑干听觉诱发电位（BAEP）潜伏期指标及脑电图synek分级，并通过SPECT/CT评价脑血流灌注情况。结果：治疗1月后，观察组运动感觉皮质、丘脑区的血流灌注量显著高于对照组（P<0.05）；两组运动感觉海马区的血流灌注量相比，差异无统计学意义（P>0.05）。观察组脑电图synek分级中Ⅰ~Ⅲ级的占比高于对照组（P<0.05）；观察组平均血流速度、局部脑血流量、局部脑血容量指标显著高于对照组（P<0.05）。观察组左、右耳BAEP的Ⅰ、Ⅲ、Ⅴ、Ⅰ~Ⅲ、Ⅲ~Ⅴ级潜伏期均短于对照组（P<0.05）。随访6个月后观察组清醒、微意识状态占比高于对照组（P<0.05）。结论：在常规治疗基础上加以右正中神经刺激疗法用于sTBI患者，可显著增加其伤侧皮质、丘脑区血流灌注量，促进脑电图synek分级、脑血流动力学水平、神经功能改善，缩短BAEP潜伏期，有利于改善预后。
Abstract:
Abstract: Objective To analyze the therapeutic effect of right median nerve stimulation therapy combined with conventional treatment in patients with severe traumatic brain injury (sTBI). Methods Sixty patients with sTBI were enrolled, all of whom were in coma, and the Glasgow coma score was lower than 9. The patients in control group (n=30) were treated with conventional treatment, while those in observation group (n=30) received right median nerve stimulation therapy in addition to conventional treatment, with the treatment cycle of 1 month. The two groups were compared in terms of therapeutic effect, cerebral hemodynamics, brainstem auditory evoked potential (BAEP) latency, and electroencephalogram (EEG) synek grade, and the cerebral blood perfusion was evaluated with SPECT/CT. Results After 1 month of treatment, the blood perfusion volume of motorsensory cortex and the thalamus in observation group was significantly higher than that in control group (P<0.05), and there was no significant difference in the blood perfusion volume of the hippocampus between two groups (P>0.05). The proportions of EEG synek grade I-Ⅲ, average blood flow velocity, regional cerebral blood flow (rCBF) and regional cerebral blood volume (rCBV) were higher in observation group than in control group (all P<0.05). The latency of BAEP Ⅰ, Ⅲ, Ⅴ, I-Ⅲ, Ⅲ-V in the left and right ear of observation group were shorter than those of control group (P<0.05). The 6-month follow-up showed that the proportion of conscious state and minimally conscious state was higher in observation group than in control group (P<0.05). Conclusion The combination of conventional treatment with right median nerve stimulation for sTBI can significantly increase the blood perfusion volume in the injured cortex and thalamus, promote the improvements of EEG synek grade, cerebral hemodynamics and nerve function, shorten BAEP latency, and improve the prognosis.

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备注/Memo

备注/Memo:
【收稿日期】2023-09-02 【基金项目】江苏省卫健委课题（K2019018） 【作者简介】杜延平，硕士，副主任医师，研究方向：脑血管病及颅脑创伤，E-mail: duyanping1123@163.com 【通信作者】梁建广，主任医师，研究方向：颅脑创伤、脑出血及脑积水，E-mail: zyyljg@126.com
更新日期/Last Update: 2023-11-24