多重感觉刺激对重型颅脑损伤昏迷的促醒作用

摘要

Objective To invesligale the effect of multi - sensory slimulalion on comatose patienls after Lraumatic brain injury. Methods Thirty - six comalose palienls with coma over 8 hours and Glasgow Coma Scales 3-8 were divided into two groups at random. The conlrol group ( n = 18 ) received rouline nursing while the study group ( n = 18 ) received rouline nursing plus mulli - sensory slimulalion. GCS scores, the rale of awakening and lime of awakening after trealmenl in the two groups were compared. Results Thirly days after trealmenl,the GCS scores in the sludy group( 10. 22 ±3. 59) were higher than those in the conlrol group(7. 94 ±2. 98) , wilh significant difference (P<0. 05) . Six monlhs later,the GCS scores and the rale of awakening in the sludy group were higher lhan ihose in the conlrol group while the lime of awakening in the sludy group (17. 23 ± 8. 78) was shorter lhan that in the conlrol group (27. 20 ± 10. 02) (P <0. 05). Conclusions Mulli - sensory slimulalion Irealmenl conlribules to awakening palienls wilh severe TBI, promole functional recovery of palienls' brain and increase the rale of awakening.%目的 探讨多重感觉刺激对重型颅脑损伤昏迷(severe traumatic brain injury,STBI)的促醒作用.方法 将昏迷时间超过8 h,格拉斯哥昏迷评分(glasgow coma scale,GCS) 3～8分的STBI患者36例,随机分成两组.对照组采用常规护理方法,实验组在此基础上,采用听觉(亲情呼唤、音乐疗法)、视觉、触觉、嗅觉、运动等多重感觉刺激方法进行干预,并采用GCS评估干预30 d后患者情况,随访并记录平均清醒时间、清醒率.结果 治疗30 d后,实验组GCS评分(10.22±3.59)明显高于对照组(7.94±2.98),差异有统计学意义(P＜0.05);随访6个月时,实验组清醒13例,昏迷时间4～35 d,平均(17.23±8.78)d,对照组清醒人数7例,昏迷时间8～41 d,平均(27.20±10.02)d.实验组昏迷时间明显短于对照组,两组之间清醒率、平均昏迷时间比较,差异有统计学意义(P＜0.05).结论 多重感觉刺激对STBI患者有一定的促醒效果,对降低患者伤残率和促进患者早日康复具有积极作用.