脊髓刺激治疗对长期意识障碍患者及其护理人员的影响：一项随访研究

IF 0.4 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management Pub Date : 2025-06-01 DOI:10.1016/j.inat.2025.102061

Jing Liu , GuangXu Zhang , Feng Cao

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引用次数: 0

摘要

长期意识障碍（pDoC）是指由于严重脑损伤导致意识水平长期下降的疾病，包括植物人状态和最低意识状态。这些患者的康复时间较长，显著影响照顾者的心理压力、身体负担和家庭生活。本研究旨在评估脊髓刺激（SCS）对pDoC患者治疗的影响及其对主要照顾者负担和心理健康的影响。方法本研究回顾了2020年8月至2023年12月在南京医科大学附属脑科医院接受SCS治疗的32例pDoC患者及其护理人员。术前及术后1、6、12个月随访采用昏迷恢复量表-修正量表（CRS-R）对患者进行评估，护理人员采用Zarit负担访谈（Zarit）、Zung抑郁自评量表（SDS）和焦虑自评量表（SAS）进行评估。结果经SCS治疗后，23例患者意识明显改善。护理人员的Zarit、SDS和SAS评分术后显著降低，表明家庭负担、抑郁和焦虑减轻。CRS-R评分的改善与照顾者负担的减轻显著相关。结论脊髓刺激对pDoC患者意识恢复有积极影响，同时间接减轻照顾者的照顾负担和心理压力，从而改善照顾者的精神状态。

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The impact of spinal cord stimulation treatment on patients with prolonged disorders of consciousness and their caregivers: A follow-up study

Objective

Prolonged disorders of consciousness (pDoC) are conditions characterized by a long-term reduction in consciousness level due to severe brain injury, including vegetative state and minimally conscious state. The rehabilitation for these patients is prolonged, significantly impacting the psychological stress, physical burden, and family life of their caregivers. This study aims to evaluate the effects of spinal cord stimulation (SCS) on the treatment of patients with pDoC and its impact on the burden and mental health of primary caregivers.

Methods

The study reviewed 32 patients with pDoC and their caregivers who underwent SCS at the Affiliated Brain Hospital of Nanjing Medical University between August 2020 and December 2023. Patients were assessed using Coma Recovery Scale-Revised scale (CRS-R), and caregivers were evaluated using the Zarit Burden Interview (Zarit), Zung Self-Rating Depression Scale (SDS), and Self-Rating Anxiety Scale (SAS) at pre-surgery and 1, 6, and 12 months post-surgery follow-ups.

Results

After receiving SCS treatment, 23 patients showed significant improvement in consciousness. Caregivers’ Zarit, SDS, and SAS scores significantly decreased post-surgery, indicating alleviation of family burden, depression, and anxiety. The improvement in CRS-R scores was significantly correlated with the reduction in caregiver burden.

Conclusion

Spinal cord stimulation positively impacts consciousness recovery in patients with pDoC, while indirectly reducing caregiving burden and psychological stress for their caregivers, thus improving their mental state.

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