[1]冯 枫.重复经颅磁刺激联合常规促醒在颅脑损伤后意识障碍患者治疗中的临床应用研究*[J].陕西医学杂志,2020,49(4):442-445.
　FENG Feng..The role of repetitive transcranial magnetic stimulation combined with conventional wake-up therapy in the treatment of patients with disturbance of consciousness after craniocerebral injury[J].,2020,49(4):442-445.
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重复经颅磁刺激联合常规促醒在颅脑损伤后意识障碍患者治疗中的临床应用研究*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年4期
页码:
442-445
栏目:
临床研究
出版日期:
2020-04-05

文章信息/Info

Title:
The role of repetitive transcranial magnetic stimulation combined with conventional wake-up therapy in the treatment of patients with disturbance of consciousness after craniocerebral injury
文章编号:
DOI:10.3969/j.issn.10007377.2020.04.014
作者:
冯 枫
空军军医大学西京医院康复医学科(西安 710032)
Author(s):
FENG Feng.
Department of Rehabilitation Medicine,Xijing Hospital(Xi'an 710032)
关键词:
康复治疗;  意识障碍;  颅脑损伤;  重复经颅磁刺激;  促醒;  疗效
Keywords:
Rehabilitation therapy;  Disturbance of consciousness;  Craniocerebral injury;  Repetitive transcranial magnetic stimulation;  Wake-up;  Therapeutic effect
分类号:
R651.1
文献标志码:
A
摘要:
目的:探讨常规多感觉刺激疗法促醒治疗基础上,使用重复经颅磁刺激(rTMS)(20 Hz)治疗颅脑损伤后意识障碍的临床效果。方法:采用随机数字表法将在本院接受康复治疗的88例颅脑损伤意识障碍患者分为两组,每组各44例。对照组仅接受常规促醒治疗; 试验组在对照组治疗基础上,进行频率为20 Hz的rTMS治疗。采用修订版昏迷恢复量表(CRS-R)和残疾评分量表(DRS)评分法评估两组治疗前后意识和功能恢复情况; 测定对比两组治疗前后脑电图、脑干听觉诱发电位(BAEP)改善情况。结果:与治疗前比,两组治疗后CRS-R评分明显提高,DRS评分明显下降,synek分级改善更明显(P<0.05)。治疗后组间比较,试验组CRS-R评分明显高于对照组,DRS评分低于对照组,脑电图synek分级优于对照组,左耳和右耳部位BAEP的Ⅰ级、Ⅲ级、Ⅴ级、Ⅰ～Ⅲ级、Ⅲ～Ⅴ级波潜伏期明显短于对照组(P<0.05)。结论:常规促醒治疗联合rTMS治疗,可有效改善颅脑损伤后意识障碍患者神经功能及意识状态,可更好的发挥促醒治疗效果。
Abstract:
Objective:To explore the clinical effect of repetitive transcranial magnetic stimulation(rTMS)(20 Hz)in the treatment of conscious disturbance after craniocerebral injury based on conventional multiple sensory stimulation therapy. Methods:Eighty-eight patients who received rehabilitation treatment because of consciousness disorder after craniocerebral injury were randomly divided into control group and experimental group,44 cases in each group. The control group was treated only with conventional wake-up treatment. The experimental group was treated with rTMS at a frequency of 20 Hz on the basis of the control group. The consciousness and functional recovery were assessed by using the revised Coma Recovery Scale(CRS-R)and Disability Rating Scale(DRS)before and after treatment in two groups. The electroencephalogram and brainstem auditory evoked potential(BAEP)in the two groups were compared before and after treatment. Results:The CRS-R scores of the two groups were significantly improved after treatment,the DRS scores were significantly decreased,the improvement of synek grade was more obvious(P<0.05). After treatment,the CRS-R score of the experimental group was significantly higher than that of the control group,the DRS score was lower than that of the control group,the electroencephalogram synek classification was better than that of the control group,and the latency of grade Ⅰ,Ⅲ,Ⅴ,Ⅰ to Ⅲ,and Ⅲ to Ⅴ of BAEP in the left and right ears was significantly shorter than that of the control group(P<0.05). Conclusion:Conventional wake-up therapy combined with rTMS treatment can effectively improve the neurological function and consciousness state of patients with disturbance of consciousness after craniocerebral injury,and can better exert the effect of wake-up treatment.

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备注/Memo

备注/Memo:
*陕西省自然科学基金资助项目(2013F1-18)
更新日期/Last Update: 2020-04-13