经颅磁刺激在脑梗死患者运动功能康复中的效果  

Effect of transcranial magnetic stimulation on rehabilitation of motor function in patients with cerebral infarction

作　　者：金鑫[1] 吴小未[1] 王俊芳[1] 黄碧波[1] 王全录[1] 张通[2] 钮竹[2] 张晓明[1] 

机构地区：[1]首都医科大学附属复兴医院神经内科,100038 [2]中国康复研究中心神经内科

出　　处：《中华医学杂志》2002年第8期534-537,共4页National Medical Journal of China

摘　　要：目的　探讨经颅磁刺激 (TMS)在促进脑梗死运动功能康复中的作用。方法　在基本治疗相同的情况下 ,将TMS康复治疗的脑梗死患者分组比较 ,观察FMA评分、Barthel指数评分 ,进行临床疗效比较。结果　经TMS治疗后的康复组 6 3例 (有效率 90 5 % )明显优于对照组 6 0例 (有效率6 8 3% ) ;TMS康复治疗对 75岁以下患者有效 (P <0 0 0 1) ,对 75岁以上患者疗效趋向不显著 (P >0 0 5 ) ;发病 3个月内组经TMS治疗后的FMA评分为 5 9 0± 2 2 8,发病 3个月后进行TMS康复治疗组治疗后的FMA评分为 4 5 4± 14 8,发病 3个月内尽早康复治疗优于发病 3个月后进行TMS康复治疗组。结论　TMS康复运动功能疗效肯定 ,且其康复疗效受年龄影响 。Objective To study the effect of transcranial magnetic stimulation (TMS) on the rehabilitation of motor function in patients with cerebral infarction Methods Two hundred twenty and three patients with the initial attack of cerebral infarction were divided into three groups (1) One hundred twenty and three patients were randomly further divided into rehabilitation subgroup ( n =63, aged 64 0±7 9, treated with TMS beginning from the 6～10 th day after onset) and control subgroup ( n =60, aged 63 5±7 9) (2) Sixty patients were divided into three subgroups according to the age: 35～55 ( n =11), 56～75 ( n =20), and over 76 ( n =30) (3) Forty patients aged 56～75 were further divided into two subgroups according to the timing of beginning of TMS: subgroup with TMS beginning within 3 months after the initial attack ( n =20) and subgroup with TMS beginning 3 months after the initial attack ( n =20) Except for TMS, the basic treatment was the same for all of the patients TMS was given once a day for 14 days Fugl Meyer score, Barthel index, and central spinal cord motor conduction time (CMCT) were measured twice: just before treatment and after the 14th treatment A difference less than 20 ms between CMCT values measured before and after TMS and failure to induce CMCT both before and after TMS were regareded as ineffective hess, and a difference more than 20 ms between CMCT values measured before and after TMS and a change from failure to induce CMCT were regareded as effective hess Results The effective rate was 90 5% in the rehabilitation subgroup and 68 3% in the control group ( P <0 05) The Fugl Meyer scores were 36 3±15 8 and 33 7±13 7 in the rehabilitation subgroup and control subgroup before treatment respectively ( P >0 05), and were 51 7±15 7 and 40 0±13 9 after treatment respectively ( P <0 01) The Barthel index were 39 6±15 8 and 40 0±14 9 in the two subgroups before treatment respectively ( P >0 05) and were 50 5±15 7 and 4

关 键 词：运动功能 经颅磁刺激 脑梗死 功能康复 

分 类 号：R743.33[医药卫生—神经病学与精神病学]