低频重复经颅磁刺激对颅脑损伤后植物状态患者的促醒作用  

Awakening efficacy of low frequency repetitive transcranial magnetic stimulation for the patients with vegetative state after craniocerebral injury

作　　者：吕超[1] 费舟[1] 胡学安[1] 罗鹏[1] 张磊[1] 李三中[1] 胡世颉[1] 李兵[1] 

机构地区：[1]第四军医大学西京医院神经外科,陕西西安710032

出　　处：《中国医药导报》2016年第17期69-72,共4页China Medical Herald

摘　　要：目的观察并探讨低频重复经颅磁刺激对颅脑损伤后植物状态患者的促醒作用。方法收集2013年7月-2015年6月第四军医大学西京医院收治的颅脑损伤后植物状态62例患者为研究对象,按照随机数字表法将其随机分为观察组和对照组,各31例。对照组患者给予常规康复治疗,观察组在康复治疗的基础上给予低频重复经颅磁刺激治疗,疗程4周。比较两组患者治疗前后肯尼迪昏迷恢复量表（CRS-R）评分,检查两组患者脑干听觉诱发电位,评估患者脑功能恢复情况。结果观察组治疗后CRS-R评分较治疗前显著升高[（7.38±1.74）分比（3.24±0.43）分]（P〈0.05）,且明显高于对照组治疗后[（3.35±0.88）分]（P〈0.05）。观察组治疗后左侧脑干及右侧脑干听觉诱发电位的5个波（Ⅰ波、Ⅲ波、Ⅴ波、Ⅰ-Ⅲ波、Ⅲ-Ⅴ波）潜伏期均显著短于对照组（P〈0.05）。两组患者治疗中均未出现癫痫发作。结论低频重复经颅磁刺激可显著改善颅脑损伤后植物状态患者中枢神经功能及意识状态,对患者促醒有一定作用。Objective To observe and discuss the awakening efficacy of low frequency repetitive transcranial magnetic stimulation for the patients with vegetative state after craniocerebral injury. Methods Sixty two cases of patients with vegetative state after craniocerebral injury admitted to Xijing Hospital, the Fourth Military Medical University from July2013 to June 2015 were selected as research objects and they were randomly divided into observation group and control group by random number table, with 31 cases in each group. The control group was treated with routine rehabilitation treatment, on basis of routine rehabilitation treatment, the observation group was given low frequency repetitive transcranial magnetic stimulation, the course was 4 weeks. The scores of Kennedy coma recovery scale-revised（CRS-R） of the two groups before and after treatment were compared, the brainstem auditory evoked potential of the two groups were checked, so as to assess the recovery conditions of brain function. Results After treatment, the CRS-R score of the observation group was increased significantly compared with that before treatment [（7.38 ±1.74） points vs（3.24±0.43） points]（P〈0.05）, which was also significantly higher than that of control group [（3.35 ±0.88） points]（P〈0.05）.The incubation period of five waves（Ⅰ, Ⅲ, Ⅴ, Ⅰ-Ⅲ, Ⅲ-Ⅴ） of auditory evoked potential in left brainstem and right brainstem after treatment in the observation group was significantly shorter than those of control group（P〈0.05）. Both groups had no epileptic seizure during treatment. Conclusion Low frequency repetitive transcranial magnetic stimulation can significantly improve the function of central nervous system and consciousness of patients with vegetative state after craniocerebral injury, which has a certain action in promoting awakening for the awakening of patients.

关 键 词：低频重复经颅磁刺激 颅脑损伤 植物状态 促醒 

分 类 号：R651.150.6[医药卫生—外科学]