【摘要】：目的:系統(tǒng)評價正中神經(jīng)電刺激與常規(guī)促醒療法在治療昏迷患者療效上的不同效果。方法:計算機檢索CNKI、Wan Fang Data、VIP、中國生物醫(yī)學(xué)文獻數(shù)據(jù)庫和Pub Med及Web of Science,收集了關(guān)于正中神經(jīng)電刺激治療與常規(guī)昏迷促醒治療的隨機對照試驗(RCT),檢索時間均從建庫至2016年5月。由2名研究者按照納入與排除標準篩選文獻,提取數(shù)據(jù)和評價納入研究的方法學(xué)質(zhì)量后,采用Rev Man 5.1.0軟件進行meta分析。結(jié)果:納入12個研究,1001例患者,觀察組503例,對照組498例。正中神經(jīng)電刺激能提高GCS評分:2—4周(Z=3.24,P0.01),8周(Z=3.44,P0.01);有改善腦干誘發(fā)電位(Z=2.66,P0.01),腦電圖(Z=3.05,P0.01)和患者言語功能(Z=4.30,P0.01)的效果,差異有顯著性意義。結(jié)論:正中神經(jīng)電刺激療法可以提高患者GCS評分,改善腦血流量,對促進患者清醒有較好效果,由于受納入研究質(zhì)量和樣本量的影響,今后仍需開展大樣本,高質(zhì)量的RCT進行驗證。
[Abstract]:Objective: to evaluate the efficacy of median nerve stimulation and conventional wake-up therapy in the treatment of coma patients. Methods: CNKI,Wan Fang Data,VIP, Chinese biomedical literature database, Pub Med and Web of Science, were searched by computer. The retrieval time of (RCT), in the randomized controlled trials of median nerve electrical stimulation therapy and conventional coma wake-up therapy was from the establishment of the database to May 2016. According to the inclusion and exclusion criteria, two researchers sifted the literature, extracted the data and evaluated the methodological quality of the study. The meta analysis was carried out with Rev Man 5.1.0 software. Results: one hundred and one patients were enrolled in 12 studies, 503 cases in the observation group and 498 cases in the control group. Median nerve stimulation could improve the GCS score from 2 to 4 weeks (Z = 3.24 鹵P0.01) to 8 weeks (Z = 3.44 vs P0.01), improve the brainstem evoked potential (ZG), electroencephalogram (EEG) and speech function of the patients (ZH 4.30P0.01). Conclusion: median nerve electrical stimulation therapy can improve the GCS score, improve cerebral blood flow and promote the patients' wakefulness. Due to the influence of the quality and sample size of the included study, it is necessary to carry out large samples in the future. High quality RCT is verified.
【作者單位】： 南昌大學(xué)第一附屬醫(yī)院康復(fù)醫(yī)學(xué)科;
【基金】：國家自然科學(xué)基金資助項目(81260295) 江西省自然科學(xué)基金資助項目(20132BAB205063) 江西省衛(wèi)生廳科技計劃項目(20131026)
【分類號】：R651.15
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本文編號：2215216