| Objective:To study the correlation between injury site and consciousness recovery in traumatic brain injury patients with chronic consciousness disorder.Methods:75 patients with chronic consciousness disorder caused by traumatic brain injury were collected from Rehabilitation Medicine Department of Shanxi Bethune Hospital from February 2017 to July 2022.Skull imaging examination(including skull CT and MRI)was performed on them to analyze the structural damaged parts of the patients.Four different levels of consciousness were divided into coma,vegetative state/unresponsive awakening syndrome,minimal conscious state and minimal conscious state out according to the Revised coma scale-revised(CRS-R)scale.The CRS-R scale was evaluated again at 4 months after the disease onset.To judge the degree of consciousness recovery,generalized estimation equation method and multiple linear regression method were used to sum up the affected parts of consciousness recovery.Results:A total of 75 patients with disturbance of consciousness,with a baseline mean age of 52 years,were included in the study,including 57 males(76%)and 18 females(24%).There were 8 patients in coma(10.6%),32 patients in VS(42.7%),29 patients in MCS(38.7%),and 6 patients in e MCS(8%).Generalized estimation equation method was used to conclude that the injury of brain stem and basal ganglia was closely related to the degree of consciousness disorder of patients,among which,the degree of consciousness disorder of patients with brain stem injury(OR=2.996,95%CI:2.164-4.149)and basal ganglia injury(OR=3.114,95%CI: 2.513-3.859)was deep.Compared with 4 months after the onset of the disease,the degree of consciousness disorder was deeper 1 month after the onset of the disease(OR=2.755,95%CI: 2.108-3.601),and the consciousness level of both groups could be improved to a certain extent after rehabilitation treatment.Secondly,the difference between the two measures of conscious state score was taken as the evaluation index of prognosis and as the dependent variable,and age,gender,and loss of various parts of the brain were taken as independent variables.After variable screening by multiple linear regression method,the following results were obtained:4 months after the onset of the disease,the injured group had a poor recovery of consciousness compared with the brain stem and basal ganglia non-injured group,which was statistically significant(P<0.05).Conclusion:(1)In TBI patients,patients with brain stem and basal ganglia injury had more severe Do C;(2)In TBI patients,patients with brain stem and basal ganglia injury had worse consciousness recovery in the later stage than patients without injury here. |
