《中国康复理论与实践》

《中国康复理论与实践》 ›› 2015, Vol. 21 ›› Issue (03): 303-306.

• 临床研究 • 上一篇    下一篇

脑电仿生电刺激对持续植物状态患者脑血流速度和脑代谢的影响

倪莹莹1a，邓丽霞1a，邱承尧1a，汪文胜1b，马梦良1a，刘云义1a
   

  1. 1.广东三九脑科医院，a.神经康复科；b.影像科，广东广州市510510。
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-03-25 发布日期:2015-03-25

Effect of Electroencephalograph Bionic Electrical Stimulation on Persistent Vegetative State: Cerebral Blood Flow and Metabolism

NI Ying-ying1a, DENG Li-xia1a, QIU Cheng-yao1a, WANG Wen-sheng1b, MA Meng-liang1a, LIU Yun-yi1a
   

  1. 1. a. Department of Neurological Rehabilitation; b. Department of Image, Guangdong 999 Brain Hospital, Guangzhou, Guangdong 510510, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-03-25 Online:2015-03-25

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被引次数

11

摘要： 目的研究脑电仿生电刺激完骨、天柱、内关对持续植物状态(PVS)患者脑血流速度及脑代谢的影响。方法60 例PVS患者按照随机数字表法分为观察组和对照组各30 例，对照组接受基础管理、高压氧、促醒药物、感觉刺激等常规治疗；观察组在常规治疗基础上接受脑电仿生电刺激双侧天柱、完骨(主电极)、内关穴(辅助电极)治疗，连续治疗30 d。分别于治疗开始前1 d及治疗结束后1 d 采用PVS疗效评分量表进行评估，经颅彩色多普勒超声(TCD)、磁共振波普(MRS)检查观察脑血流速度及脑代谢变化。结果观察组总有效率为86.67%，优于对照组的60.00% (P<0.05)。观察组大脑前动脉-大脑中动脉、大脑后动脉-椎动脉-基底动脉治疗前后平均流速改变(ΔVm)均明显高于对照组(P<0.01)。治疗后观察组N-乙酰天门冬氨酸/肌酸明显高于对照组(P<0.01)，胆碱复合物/肌酸明显低于对照组(P<0.01)。结论脑电仿生电刺激完骨、天柱、内关可明显改善PVS患者脑循环及脑代谢，有可能提高临床促醒疗效。

关键词: 持续植物状态, 脑电仿生电刺激, 脑血流速度, 脑代谢

Abstract: Objective To study the effect of electroencephalograph (EEG) bionic electrical stimulation at Wangu (GB12), Tianzhu (BL10), Neiguan (PC6) on cerebral blood flow and metabolism in patients with persistent vegetative state (PVS). Methods 60 patients with PVS were divided into observation group (n=30) and control group (n=30) according to the random number table. The control group received routine treatment, including basic management, hyperbaric oxygen therapy, awaking medicine, sensory stimulation, and so on; while the observation group received EEG bionic electrical stimulation at bilateral Tianzhu, Wangu (cheif electrodes) and Neiguan (auxiliary electrodes) in addition. They were treated for 30 days. They were assessed with the PVS score, and observed with transcranial Doppler ultrasound (TCD) and magnetic resonance spectroscopy (MRS) one day before and one day after treatment. Results The incidence of improvement was 86.67% in the observation group, more than 60.00% in the control group (P<0.05). The difference of blood flow velocity before and after treatment (ΔVm) of anterior-middle cerebral artery was more in the observation group than in the control group respectively (P< 0.001), as well as those of posterior cerebral-vertebral-basilar artery (P<0.01). The N-acetyl aspartic acid/creatine (NAA/Cr) increased more in the observation group than in the control group respectively (P<0.01), and the choline/creatine (Cho/Cr) decreased more (P<0.01), after treatment. Conclusion EEG bionic electrical stimulation can improve the cerebral circulation and metabolism in patients with PVS, which may associate with the wake promoting.

Key words: persistent vegetative state, electroencephalograph bionic electrical stimulation, cerebral blood flow velocity, cerebral metabolism