| Background Coma is one of the more serious complications of craniocerebral trauma.In recent years,with the improvement of rescue ability and treatment level of craniocerebral trauma,the mortality of craniocerebral trauma patients has been improved,but how to make the situation of coma patients significantly improved,and then improve the prognosis is an important clinical problem.The experiment shows that hyperbaric oxygen therapy can improve the oxygen and blood supply of damaged brain tissue,and the vicious circle of ischemia edema ischemia can also be significantly changed,which is beneficial to the recovery of patients’ consciousness;Right median nerve stimulation(RMNS)is a kind of non-invasive electrical stimulation,which is safe and can be applied in the early stage of coma.However,there are few studies on the combination of the above two therapies.This study mainly focuses on the application of RMNS combined with hyperbaric oxygen therapy in coma patients with brain injury to explore its efficacy.ObjectiveTo investigate the clinical value of right median nerve stimulation(RMNS)combined with hyperbaric oxygen in the treatment of coma patients with head injury.Method In a retrospective study,138 coma patients with craniocerebral injury who met the inclusion criteria in neurosurgery department of our hospital from October 2018 to September 2021 were selected as the study objects,and randomly divided into control group(69 cases)and study group(69 cases).The control group was mainly given traditional therapies such as hyperbaric oxygen,basic drugs and nutritional adjuvant therapy,while the study group was given RMNS therapy on the basis of the control group.The degree of coma,awakening time,dysfunction,changes in cerebral blood flow velocity and changes in neuroelectrophysiology before and 7 days,14 days,1 month and 3 months after treatment were compared and analyzed.Result After 7 days,14 days,1 month and 3 months of treatment,compared with the control group,the effective rate of recovery of all patients in the study group was higher than that in the control group(P<0.05);The GCS score and CRS-R score in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05);Compared with the control group,the FOUR score of the study group was higher than that of the control group,and the DRS score was lower than that of the control group,with a significant difference(P<0.05);Compared with the control group,the hemodynamic indexes of MCA,ACA and BA were significantly higher in the treatment group at 7 days,14 days,1 month and 3 months(P<0.05);Compared with the control group,on the 7th,14 th,1st and 3rd day after treatment,EEG changes in the study group were significantly improved compared with the control group,and the amplitude of waveform changes was significantly greater than that in the control group(P<0.05);The characteristics of EEG changes were mainly reflected in the diffuse slow wave that dominated sleep θ Wave δ The wave level decreases gradually;Dominant arousal α、β The rhythm and amplitude of the wave increased,with a significant difference(P<0.05);Compared with the control group,the change of BAEP in the study group was significantly higher than that in the control group 7 days,14 days,1 month and 3 months after treatment(P<0.05).The change of BAEP was mainly manifested in the shortening of I-V peak latency,III-V peak latency,especially III-V peak latency,and the amplitude of III-V wave increased(P<0.05).Conclusion The combination of right median nerve electrical stimulation(RMNS)and hyperbaric oxygen therapy is better than hyperbaric oxygen therapy alone in the treatment of coma patients with craniocerebral injury.It can accelerate the recovery of coma patients,effectively shorten the time of coma,and significantly improve the coma and disability conditions,which is worthy of clinical promotion. |
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