A retrospective analysis of factors affecting the recovery of prolonged disorders of consciousness and treatment strategies following brain injury
10.3969/j.issn.1001-1242.2024.08.006
- VernacularTitle:脑损伤后慢性意识障碍康复影响因素及治疗策略的回顾性分析
- Author:
Zhijie HE
1
;
Junfa WU
1
;
Xinwei TANG
1
Author Information
1. 复旦大学附属华山医院康复医学科,上海市,200040
- Publication Type:Journal Article
- Keywords:
prolonged disorders of consciousness;
influencing factors;
rehabilitation therapy;
brain injury
- From:
Chinese Journal of Rehabilitation Medicine
2024;39(8):1122-1129,1142
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the potential factors influencing the recovery of consciousness levels during the rehabil-itation process of patients with prolonged disorders of consciousness (DOC) following brain injury,and to as-sess the impact of different treatment strategies on consciousness level recovery.Method:A retrospective analysis was conducted on clinical data,consciousness level scores,clinical medica-tion usage,and rehabilitation treatment plans of 72 patients with DOC who were admitted to our rehabilitation medicine department from 2017 to 2022.Result:Factors such as difficulty in tracheostomy tube removal,hydrocephalus,elevated muscular tension ab-normalities,poor infection control,and inadequate control of non-infectious complications significantly affected the improvement of consciousness levels. Regarding medications,the injection of botulinum toxin for muscular tension control and the use of amantadine had a significant impact on improving consciousness levels. The use of selective serotonin reuptake inhibitors (SSRIs) showed a trend towards improving consciousness levels,but the differences were not statistically significant.Conclusion:During the rehabilitation process of patients with DOC following brain injury,addressing factorsthat influence consciousness levels is crucial. These factors include effective infection control,management of complications,early removal of tracheostomy tubes when feasible,active management of hydrocephalus,local injection of botulinum toxin to control elevated muscular tension,and the use of medications that may im-prove consciousness levels,such as amantadine and SSRIs.
