Clinical study of median nerve electrical stimulation on coma induced by severe traumatic brain injury in NICU

doi:10.3877/cma.j.issn.2095-9141.2021.01.004

Abstract

Abstract:

Objective

To investigate the clinical effect of median nerve electrical stimulation on coma induced by severe traumatic brain injury (sTBI) in neurosurgical intensive care unit (NICU) and its possible mechanism.

Methods

A prospective study was conducted on 83 patients with sTBI admitted to Neurosurgery Department of 900^th Hospital of the Joint Logistics Team from June 2019 to July 2020. They were randomly divided into experimental group (n=42) and control group (n=41). The control group was given conventional treatment, and the experimental group was supplemented with median nerve electrical stimulation (early intervention in NICU) on the basis of conventional treatment. GCS score, plasma nerve injury index [collagen fibrillary acidic protein(GFAP), ubiquitin carboxyl terminal hydrolase-L1 (UCH-L1)] and neurotrophic index [plasma brain-derived nerve growth factor (BDNF)] were compared between the two groups before and after treatment to evaluate the therapeutic effect.

Results

There was significant difference in GCS score between the two groups after treatment (P<0.05), and the GCS score of the experimental group was higher than that of the control group. There were significant differences in the levels of GFAP, UCH-L1 and BDNF between the two groups after treatment (P<0.05), the decrease of GFAP and UCH-L1 in the experimental group was greater than that in the control group, and the increase of BDNF in the experimental group was greater than that in the control group.

Conclusion

For comatose patients with sTBI, early median nerve stimulation can significantly improve the prognosis of patients, which is worthy of promotion and application in NICU.

Key words: Severe traumatic brain injury, Electrical stimulation of median nerve, Neurosurgical intensive care unit, Wake up

Liang Xue, Xizhen Wang, Yehuang Chen, Huijian Zhang, Liangfeng Wei, Shousen Wang. Clinical study of median nerve electrical stimulation on coma induced by severe traumatic brain injury in NICU[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2021, 07(01): 17-20.

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References 20

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项目		试验组(n=42)	对照组(n=41)	t/χ²值	P值
男/女		34/8	32/9	0.107	0.743
年龄（岁，±s）		42.3±14.45	39.7±13.10	0.678	0.874
致伤因素[例(%)]				0.524	0.469
	车祸	31(73.8)	33(80.5)
	高处坠落	11(26.2)	8(19.6)
受伤部位[例(%)]				0.861	0.768
	额颞顶部	35(83.3)	33(80.5)
	枕部	2(4.8)	4(9.7)
	额颞顶枕部	5(12.0)	4(9.6)
手术例数[例(%)]		38(90.5)	35(85.4)	0.143	0.706

项目		试验组(n=42)	对照组(n=41)	t/χ²值	P值
男/女		34/8	32/9	0.107	0.743
年龄（岁，±s）		42.3±14.45	39.7±13.10	0.678	0.874
致伤因素[例(%)]				0.524	0.469
	车祸	31(73.8)	33(80.5)
	高处坠落	11(26.2)	8(19.6)
受伤部位[例(%)]				0.861	0.768
	额颞顶部	35(83.3)	33(80.5)
	枕部	2(4.8)	4(9.7)
	额颞顶枕部	5(12.0)	4(9.6)
手术例数[例(%)]		38(90.5)	35(85.4)	0.143	0.706

组别	例数	治疗前	治疗后2周	治疗后1个月	F值	P值
对照组	41	5.88±1.137	7.03±1.387^a	8.03±1.330^ab	168.757	0.001
试验组	42	5.83±1.267	7.83±1.447^a	9.64±1.428^ab	364.411	0.001
t值		0.156	-2.581	-5.302
P值		0.876	0.012	0.001

组别	例数	治疗前	治疗后2周	治疗后1个月	F值	P值
对照组	41	5.88±1.137	7.03±1.387^a	8.03±1.330^ab	168.757	0.001
试验组	42	5.83±1.267	7.83±1.447^a	9.64±1.428^ab	364.411	0.001
t值		0.156	-2.581	-5.302
P值		0.876	0.012	0.001

组别	例数	GFAP				UCHL-1				BDNF
组别	例数	治疗前	治疗后2周	t值	P值	治疗前	治疗后2周	t值	P值	治疗前	治疗后2周	t值	P值
对照组	41	1.619±0.361	1.237±0.204	5.808	0.001	0.728±0.155	0.668±0.138	1.844	0.069	70.940±14.248	71.419±12.629	-0.159	0.874
试验组	42	1.615±0.315	0.901±0.186	12.673	0.001	0.740±0.115	0.500±0.097	10.320	0.001	71.070±10.321	81.578±9.530	-4.848	0.001
t值		0.050	7.824			-0.376	6.392			-0.048	-4.097
P值		0.960	0.001			0.708	0.001			0.962	0.001

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