摘要
目的:探讨重复经颅磁刺激(rTMS)联合常规康复训练治疗缺血性脑卒中的效果及对认知功能的影响。方法:选取2021年6月-2022年3月于徐州医科大学附属医院诊治的120例缺血性脑卒中患者,使用随机数字表法将其分为观察组(n=60)及对照组(n=60)。对照组行常规康复训练,观察组在对照组基础上加用rTMS。比较两组汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分、改良Barthel(MBI)评分、美国国立卫生研究院卒中量表(NIHSS)评分、神经电生理指标、凝血相关指标及洛文斯顿认知功能评定测验(LOTCA)评分。结果:治疗前,两组HAMD、HAMA、MBI及NIHSS评分比较,差异均无统计学意义(P>0.05)。治疗后,两组HAMD、HAMA、NIHSS评分均低于治疗前,观察组均低于对照组;两组MBI评分均高于治疗前,观察组高于对照组,差异均有统计学意义(P<0.05)。治疗前,两组运动诱发电位(MEP)波幅及中枢运动传导时间(CMCT)比较,差异均无统计学意义(P>0.05);治疗后,两组MEP波幅均高于治疗前,CMCT均短于治疗前,观察组MEP波幅高于对照组,CMCT短于对照组,差异均有统计学意义(P<0.05)。治疗前,两组纤维蛋白酶原(FIB)、凝血酶原时间(PT)、凝血酶时间(TT)及活化部分凝血活酶时间(APTT)水平比较,差异均无统计学意义(P>0.05);治疗后,两组FIB均低于治疗前,观察组低于对照组;PT、TT及APTT均长于治疗前,观察组均长于对照组,差异均有统计学意义(P<0.05)。治疗前,两组各项LOTCA评分比较,差异均无统计学意义(P>0.05);治疗后,两组各项LOTCA评分均高于治疗前,观察组均高于对照组,差异均有统计学意义(P<0.05)。结论:rTMS联合常规康复训练可减少缺血性脑卒中患者的神经功能缺损程度,改善心理状态并提高认知功能,效果优异。
Objective:To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)combined with conventional rehabilitation training in the treatment of ischemic stroke and its influence on cognitive function.Method:A total of 120 patients with ischemic stroke treated in the Affiliated Hospital of Xuzhou Medical University from June 2021 to March 2022 were selected,they were divided into observation group(n=60)and control group(n=60)according to random number table method.The control group received routine rehabilitation training,the observation group received rTMS on the basis of the control group.Hamilton depression scale(HAMD)scores,Hamilton anxiety scale(HAMA)scores,modified Barthel(MBI)scores and national institutes of health stroke scale(NIHSS)scores,neuroelectrophysiological indexes,coagulation related indexes and Loewenston cognitive assessment test(LOTCA)scores were compared between the two groups.Result:Before treatment,there were no significant differences in HAMD scores,HAMA scores,MBI scores and NIHSS scores between the two groups(P>0.05).After treatment,the HAMD,HAMA and NIHSS scores of both groups were lower than those before treatment,those of the observation group were lower than those of the control group,the MBI scores of both groups were higher than those before treatment,MBI score of the observation group was higher than that of the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in motor evoked potential(MEP)amplitude and central motor conduction time(CMCT)between the two groups(P>0.05);after treatment,the MEP amplitude of both groups were higher than those before treatment,the CMCT of both groups were shorter than those before treatment,the MEP amplitude of the observation group was higher than that of the control group,the CMCT of the observation group was shorter than that of the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in fibrinogen(FIB),prothrombin time(PT),thrombin time(TT)and activated partial thromboplastin time(APTT)between the two groups(P>0.05);after treatment,the FIB of both groups were lower than those before treatment,that of the observation group was lower than that of the control group,PT,TT and APTT of both group were longer than those before treatment,those of the observation group were longer than those of the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in LOTCA scores between the two groups(P>0.05);after treatment,the LOTCA scores of both groups were higher than those before treatment,those of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).Conclusion:rTMS combined with conventional rehabilitation training can reduce the degree of neurological deficits,improve psychological status and enhance cognitive function in patients with ischemic stroke,with excellent results.
作者
鲁淑谨
LU Shujin(The Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)
出处
《中国医学创新》
CAS
2022年第30期14-18,共5页
Medical Innovation of China
关键词
重复经颅磁刺激
康复训练
缺血性脑卒中
神经认知功能
Repetitive transcranial magnetic stimulation
Rehabilitation training
Ischemic stroke
Cognitive function
