N Engl J Med. 1994 May 26;330(21):1499-508. doi: 10.1056/NEJM199405263302107.
This consensus statement of the Multi-Society Task Force summarizes current knowledge of the medical aspects of the persistent vegetative state in adults and children. The vegetative state is a clinical condition of complete unawareness of the self and the environment, accompanied by sleep-wake cycles, with either complete or partial preservation of hypothalamic and brain-stem autonomic functions. In addition, patients in a vegetative state show no evidence of sustained, reproducible, purposeful, or voluntary behavioral responses to visual, auditory, tactile, or noxious stimuli; show no evidence of language comprehension or expression; have bowel and bladder incontinence; and have variably preserved cranial-nerve and spinal reflexes. We define persistent vegetative state as a vegetative state present one month after acute traumatic or nontraumatic brain injury or lasting for at least one month in patients with degenerative or metabolic disorders or developmental malformations. The clinical course and outcome of a persistent vegetative state depend on its cause. Three categories of disorder can cause such a state: acute traumatic and non-traumatic brain injuries; degenerative and metabolic brain disorders, and severe congenital malformations of the nervous system. Recovery of consciousness from a posttraumatic persistent vegetative state is unlikely after 12 months in adults and children. Recovery from a nontraumatic persistent vegetative state after three months is exceedingly rare in both adults and children. Patients with degenerative or metabolic disorders or congenital malformations who remain in a persistent vegetative state for several months are unlikely to recover consciousness. The life span of adults and children in such a state is substantially reduced. For most such patients, life expectancy ranges from 2 to 5 years; survival beyond 10 years is unusual.
多学会特别工作组的这份共识声明总结了目前关于成人和儿童持续性植物状态医学方面的知识。植物状态是一种对自我和环境完全无意识的临床状况，伴有睡眠 - 觉醒周期，下丘脑和脑干自主功能完全或部分保留。此外，处于植物状态的患者没有证据表明对视觉、听觉、触觉或有害刺激有持续的、可重复的、有目的的或自愿的行为反应；没有语言理解或表达的证据；大小便失禁；并且颅神经和脊髓反射有不同程度的保留。我们将持续性植物状态定义为急性创伤性或非创伤性脑损伤后一个月出现的植物状态，或在患有退行性或代谢性疾病或发育畸形的患者中持续至少一个月的植物状态。持续性植物状态的临床病程和结果取决于其病因。三类疾病可导致这种状态：急性创伤性和非创伤性脑损伤；退行性和代谢性脑疾病，以及严重的先天性神经系统畸形。成人和儿童创伤后持续性植物状态在12个月后恢复意识的可能性不大。成人和儿童非创伤性持续性植物状态在三个月后恢复的情况极为罕见。患有退行性或代谢性疾病或先天性畸形且持续处于植物状态数月的患者不太可能恢复意识。处于这种状态的成人和儿童的寿命会大幅缩短。对于大多数此类患者，预期寿命为2至5年；超过十年存活并不常见。
