Regaining the consciousness on long term comatose patients

• Main Authors: Jung-Tung, 劉榮東
• Other Authors: 林則彬
• Format: Others
• Language: zh-TW
• Published: 2009
• Online Access: http://ndltd.ncl.edu.tw/handle/76819877575351025391

博士 === 中山醫學大學 === 醫學研究所 === 97 === Purpose: Vegetative state or long term comatose patients are regarded as relative hopeless clinically. They are often referred to nursing home for basic care when clinical medication is over. There are few people to regain the consciousness, certainly, no possibility to back the normal life. This situation could be verified through the establishing the nursing home everywhere in Taiwan. This study was performed to describe using a peripheral nerve either combine with hyperbaric oxygenation（HBO） or not to regain the consciousness from a long term comatose patients. Background: Because neuromodulation and hyperbaric oxygen therapy have emerged some promise in treating patients with states of reduced consciousness, we evaluated the individual effect after a therapies in combinations of median nerve stimulation（MNS）with HBO, MNS only and control group in long term comatose patients. Methods: Eight-one cases enrolled in our study, 27 patients received the median nerve stimulation combined with HBO, 14 patients received median nerve stimulation only, 40 cases kept with basic care. SPECT study was performed to evaluate the cerebral perfusion. Catecholamine and neurotransmitter collected and quantified from cerebrospinal fluid（CSF）. The change of Glasgow coma scale（GCS）, Glasgow outcome scale（GOS）, respiration type and intake route were accessed to be a scale of life quality. Significant P-value was accessed with Paired student t-test or Wilcoxon signed-rank sum test. Results: MNS combined with HBO has better result than those patients with MNS only. Comparing to control group, neuromodulation therapy is optimal option for those of long term regardless with HBO or not.　 Conclusion: In fact, many patients were abandoned by physician because much information were ignored. I present this article to describe the result of coma in resuscitation by using hyperbaric oxygen and neuromodulation. Through the observation of patient’s consciousness change, we believe that neuromodulation and HBO is the best and necessary method to resuscitate the patients’ consciousness.