李姣;冯海霞;李亚斌;许东升;王红霞;杨佳丽;曹志刚;刘忠;

• 1:甘肃省康复中心医院
• 2:同济大学医学院

摘要(Abstract)：

目的观察非侵入性神经调控技术经颅直流电刺激(tDCS)结合正中神经电刺激(MNES)对脑损伤后患者意识水平和体感诱发电位的影响。方法纳入脑损伤后存在意识障碍的患者102例,随机分为3组,每组34例,A组给予常规治疗及阳极经颅直流电刺激,B组常规治疗及正中神经电刺激,C组给予常规治疗、阳极经颅直流电刺激及正中神经电刺激,分别于治疗前、治疗后4周及治疗后8周进行体感诱发电位N20潜伏期及波幅测定,格拉斯哥昏迷量表(GCS)及昏迷恢复量表(CRS-R)测评。结果 (1)体感诱发电位:3组经4周治疗后N20潜伏期均治疗前缩短、波幅均较治疗前提高(P<0.05);3组经8周治疗后,与治疗4周时相比,N20潜伏期均缩短、波幅均增高,且C组N20潜伏期[(19.06±2.01)ms]及波幅[(2.23±0.45)μV]变化显著高于A组[N20潜伏期(21.06±2.36)ms,波幅(1.99±0.36)μV]、B组[N20潜伏期(20.92±2.33)ms及波幅(2.04±0.27)μV](P<0.01)。(2)GCS、CRS-R测评:3组经4周治疗后,GCS、CRS-R量表测评分值均提高(P<0.05);治疗8周后,3组GCS、CRS-R测评得分较4周时均提高(P<0.05),A、B组提高情况接近,而C组GCS[(12.76±1.46)分]、CRS-R[(16.23±0.49)分]评分显著优于A组[GCS(11.06±1.35)分,CRS-R(13.99±0.56)分]、B组[GCS(11.52±1.82)分,CRS-R(14.04±0.33)分](P<0.05)。结论中枢结合外周的非侵入性神经调控技术对提高脑损伤后患者意识水平及体感诱发电位的改善具有显著作用。

关键词(KeyWords)： 脑损伤;神经调控技术;意识水平;体感诱发电位;促醒

Abstract:

Keywords:

基金项目(Foundation): 兰州市人才创新创业项目(编号:2019-RC-40)

作者(Authors): 李姣;冯海霞;李亚斌;许东升;王红霞;杨佳丽;曹志刚;刘忠;

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