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听觉感觉刺激后昏迷患者的认知行为恢复

Cognitive-behavioral recovery in comatose patients following auditory sensory stimulation.

作者信息

Davis Alice E, Gimenez Ana

机构信息

University of Michigan School of Nursing, Ann Arbor, MI, USA.

出版信息

J Neurosci Nurs. 2003 Aug;35(4):202-9, 214. doi: 10.1097/01376517-200308000-00006.

Abstract

Nursing therapies promote recovery following severe traumatic brain injury (TBI). However, the type and dose of treatment needed to stimulate functional plasticity have not been determined. In this quasi-experimental study, the effects of a structured auditory sensory stimulation program (SSP) were examined in 12 male patients, 17-55 years old, with severe TBI. SSP was initiated 3 days after injury and continued for 7 days. Recovery was measured by comparing baseline Glasgow Coma Scale (GCS), Sensory Stimulation Assessment Measure (SSAM), Ranchos Los Amigos Level of Cognitive Functioning Scale (RLA), and Disability Rating Scale (DRS) scores to ending scores between those who received SSP and those who did not. For the intervention group a positive recovery of function trajectory was found for mean GCS, and there was a greater improvement in GCS and RLA scores between baseline and at discharge testing periods. DRS and SSAM scores at baseline and at discharge were significantly different. SSP did not affect hemodynamic or cerebral dynamic status. Early and repeated exposure to an SSP may promote arousal from severe TBI without adversely influencing cerebral dynamic status.

摘要

护理疗法可促进重度创伤性脑损伤(TBI)后的恢复。然而,刺激功能可塑性所需的治疗类型和剂量尚未确定。在这项准实验研究中,对12名年龄在17至55岁之间的重度TBI男性患者进行了结构化听觉感觉刺激计划(SSP)的效果研究。SSP在受伤后3天开始,持续7天。通过比较接受SSP和未接受SSP的患者的基线格拉斯哥昏迷量表(GCS)、感觉刺激评估量表(SSAM)、兰乔斯·洛斯阿米戈斯认知功能水平量表(RLA)和残疾评定量表(DRS)得分与结束时得分来衡量恢复情况。对于干预组,发现平均GCS的功能轨迹呈正向恢复,并且在基线和出院测试期之间,GCS和RLA得分有更大改善。基线和出院时的DRS和SSAM得分存在显著差异。SSP不影响血流动力学或脑动力学状态。早期和反复接触SSP可能促进重度TBI患者的觉醒,而不会对脑动力学状态产生不利影响。

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