ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2019, Vol. 11 ›› Issue (4): 339-342.doi: 10.3969/j.issn.1674-3865.2019.04.017

• 临床研究 • 上一篇    下一篇

穴位电刺激正中神经对颅脑损伤患儿植物状态的临床观察

张玲，段华林，漆带丽，刘月余，胡丽，邓莹   

  1. 410007 长沙，湖南省儿童医院康复一科
  • 出版日期:2019-08-25 发布日期:2019-09-18
  • 通讯作者: 张玲，E-mail：46673267@qq.com
  • 作者简介:张玲（1983-），女，主管技师。研究方向：儿童康复的电生理治疗

Clinical observation on vegetative state of children with craniocerebral injury managed by acupoint electrical stimulation of median nerve

ZHANG Ling，DUAN Hualin，QI Daili，LIU Yueyu，HU Li，DENG Ying   

  1. Rehabilitation Department of Hunan Children's Hospital，Changsha 410007，China
  • Online:2019-08-25 Published:2019-09-18

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摘要：
目的
探究与分析穴位电刺激正中神经对颅脑损伤患儿植物状态的临床观察。
方法
选择2013年4月至2017年4月湖南省儿童医院收治的由于各种原因导致的植物状态患儿50例，随机分为观察组和对照组各25例。两组均给予常规综合康复训练，观察组在接受常规综合康复治疗同时进行穴位电刺激正中神经，每日1次，每周5次，每次30 min。连续治疗6个疗程。两组均采用修订的格拉斯哥昏迷评分量表(Glasgow)进行评分，分别在治疗前后对患儿的脑电图进行监测，同时利用经颅多普勒检查两组患儿的大脑中动脉、基底动脉的平均血流速度。
结果
观察组治疗后与对照组患儿相比脑电图异常改善情况更好，差异有统计学意义（P<0.05）。两组患儿治疗后与治疗前相比Glasgow评分均升高，观察组治疗后与对照组治疗后相比Glasgow评分升高更加显著，差异有统计学意义（P<0.05）。治疗后两组患儿两种平均血流速度均显著高于治疗前，观察组患儿两种平均血流速度显著高于对照组，差异具有统计学意义（P<0.05）。
结论
在常规治疗基础上加用穴位电刺激正中神经能够有效的发挥促醒作用，有利于植物状态患儿的康复及预后。

关键词: 植物状态, 促醒, 正中神经, 穴位电刺激, 儿童

Abstract:
Objective
To explore and analyze the vegetative state of children with craniocerebral injury managed by acupoint electrical stimulation of the median nerve.
Methods
Fifty children at vegetative state due to various causes were chosen, who were treated in Hunan Children's Hospital from Apr. 2013 to Apr. 2017. They were randomly divided into two groups: observation group(25) and control group(25). Both groups received routine comprehensive rehabilitation training. In addition, the observation group was given acupoint electrical stimulation of the median nerve, 30 min at a time, once a day, five days a week, for 6 courses in a row. The Glasgow Coma Measurement Scale(modified) was used to score in both groups. The children's EEG was monitored before and after treatment. Meanwhile, the mean flow velocity of middle cerebral artery(MCA) and basilar artery(BA) was determined by transcranial Doppler in thegroups.
Results
After treatment, the improvement in the EEG of observation group was better than that of control group(P<0.05). The Glasgow score was higher in both groups after treatment, and it was even higher in observation group than in control group(P<0.05). The mean flow velocity of the two kinds of arteries was significantly higher after treatment than before treatment in both groups, and it was higher in observation group than in control group(P<0.05).
Conclusion
The acupoint electrical stimulation of median nerve on the basis of routine treatment can play an effective role in promoting the arousal of the patients, which is beneficial to the rehabilitation and prognosis of children at vegetative state.

Key words: Vegetative state, Promote arousal, Median nerve, Acupoint electrical stimulation, Children