| Objective: To investigate the clinical effect of right median nerve electrical stimulation(RMNES)in patients with severe cognitive impairment caused by brain injury in a hyperbaric oxygen chamber.Methods:A total of 60 patients with severe consciousness disorder caused by brain injury who visited the second hospital of he bei medical university from December 2017 to February 2019 were selected.Randomly divided into control group,experimental group 1 and experimental group 2,each group had 20 people.The control group included 10 females and 10 males.They ranged in age from 19 to 65 years old,with an average age of(41±14)years.The course of the disease ranged from 7 to 29 days,with an average course of(17.4 ±1.55)days.There were 10 cases of traumatic brain injury,4 cases of cerebral hemorrhage,3 cases of cerebral infarction and 3 cases after cardiopulmonary resuscitation.In the experimental group 1,there were 9 females and 11 males.They ranged in age from 18 to 65 years,with an average age of(42.15±14.15)years.The course of the disease ranged from 7 to 25 days,with an average course of(16.65±1.33)days.There were 10 cases of traumatic brain injury,6 cases of cerebral hemorrhage,2 cases of cerebral infarction,and 2 cases after cardiopulmonary resuscitation.In the experimental group 2,there were 9 cases of female and 11 cases of male.They ranged in age from 20 to 64 years,with an average age of(42.5±13.78)years.The course of the disease ranged from 7 to 29 days,with an average course of(16.85 ±1.45)days.There were 11 cases of traumatic brain injury,2 cases of cerebral hemorrhage,3 cases of cerebral infarction and 4 cases after cardiopulmonary resuscitation.There was no difference in basic data among the three groups(P>0.05).Treatment in the control group included conventional surgical treatment,drug treatment,acupuncture and moxibustion treatment,rehabilitation treatment and Hyperbaric oxygen treatment(HBOT),etc.,once a day for 4 weeks.On the basis of treatment in the control group,experimental group 1 received RMNES treatment after the HBOT,2h/ time,once a day for 4 weeks.On the basis of treatment in the control group,the experimental group 2 received RMNES treatment in the hyperbaric oxygen chamber at the time of HBOT,2h/ time and once a day for 4 weeks.The patients' consciousness of three groups will be evaluated before and after those treatment,with consciousness Glasgow coma scale(Glasgow coma scale,GCS),Brainstem evoked potential(Brainstem auditory evoked potential,BAEP),electroencephalogram(EEG),Upper sense evoked potential(Upper sense evoked potential,USEP).Evaluate the clinical curative effect of three kinds of treatment and record the results.SPSS 21.0 software was used for statistical analysis of the obtained test data(P<0.05 was considered statistically significant).And the statistical results were discussed.Results:Before treatment,there was no difference in GCS score{(control group(5.65±1.57),experimental group 1(5.35±1.66)and experimental group 2(5.45±1.7)} between the three groups(P>0.05).EEG score was no difference {in the control group(? level 0 people,? level 9 people,? level 6 people,? level 5 people),the experimental group 1(?level 0 people,? level 7 people,? level 6 people,? level 7 people),group 2(?level 0 people,?level 8 people,? level 5 people,? level 7 people)}(P > 0.05);BAEP score was no difference {in the control group(?level 0 people,? level 7 people,? level 12 people,? level 1 people),the experimental group 1(?level 0 people,?level 6 people,? level 12 people,? level 2 people),the experimental group 2(?level 0 people,?level 6 people,? level 12 people,? level 2 people)}(P > 0.05);USEP score was no difference {in the control group(?level 0 people,?level 6 people,? level 11 people,? level 3people),the experimental group 1(?level 0 people,?level 5 people,? level 11 people,? level 4 people),the experimental group 2(?level 0 people,? level 5 people,? level 11 people,? level 4 people)}(P > 0.05).After 4 weeks of treatment,the GCS scores of the patients were improved in the three groups{(control group(6.75±0.34),experimental group 1(7.75± 1.48),experimental group 2(9.35± 1.53)}(P<0.05).EEG score was improved significantly compared with before treatment{in the control group(? level 2 people,?level 12 people,? level 5 people,? level 1 people),the experimental group 1(? level 10 people,? level 6 people,? level 4 people,? level 0 people),group 2(? level 13 people,? level 7 people,? level 0 people,? level 0 people)}(P < 0.05),and the degree of improvement among the three groups of patients was that experimental group 2 > experimental group 1 > the control group(P < 0.05);BAEP score was improved compared with before treatment(P < 0.05),{in the control group(? level 2 people,? level 13 people,? level 5 people,? level 0 people),the experimental group 1(? level 0 people,? level 15 people,? level 5 people,? level 0 people),group 2(? grade 12 people,?level 8 people,? level 0 people,? level 0 people)} and the degree of improvement among the three groups of patients was that experimental group 2 > experimental group 1 > the control group(P < 0.05);USEP score was improved compared with before treatment(P < 0.05){in the control group(? level 1 people,level ? 8 people,? level 10 people,? level 1 people),the experimental group 1(?level 3,?level 13,? level 4,? level 0 people)),group 2(? level 7 people,? level 13 people,? level 0 people,? level 0 people)};In addition,the improvement degree of patients in the three groups was that experimental group 2> experimental group 1>control group(P<0.05).Comparison of clinical efficacy among the three groups of patients: control group,0 case was basically cured,0 case was significantly effective,2 cases were effective,0 case was ineffective,and the total effective rate was 10%;In the experimental group 1,0 case was basically cured,0 case was significantly effective,7 cases were effective,and 0 case was ineffective,the total effective rate was 35%.In the experimental group 2,0 case was basically cured,1 case was significantly effective,13 cases were effective,0 case was ineffective,and the total effective rate was 70%(P < 0.05).Conclusions:RMNES can improve the consciousness state of patients with severe consciousness disorder caused by brain injury and promote their consciousness recover.And the combined treatment of RMNES at the same time of HBOT is better than the combined treatment of RMNES after the end of HBOT. |
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