磁刺激对脊髓损伤后运动功能障碍的疗效观察  

Curative effectiveness of transcranial magnetic stimulation for movement dysfunction after spinal cord injury

作　　者：王艺[1] 周贤丽[1] 侯岷[1] 张秀莉[1] 尚超平[1] 吴宗耀[1] 

机构地区：[1]第三军医大学西南医院康复科,重庆400038

出　　处：《中国康复》2016年第4期273-276,共4页Chinese Journal of Rehabilitation

摘　　要：目的:观察经颅磁刺激(TMS)联合经脊髓受损下端神经根磁刺激对不完全性脊髓损伤(SCI)患者运动功能障碍的治疗效果。方法:40例美国脊髓损伤协会(ASIA)损伤分级B^C级SCI患者,随机分为观察组和对照组各20例。对照组接受常规康复治疗;观察组在此基础上加用磁刺激治疗。2组患者在治疗前后分别比较ASIA残损分级、ASIA运动评分、SCI步行指数Ⅱ(WISCIⅡ)和运动诱发电位(MEP)的潜伏期和波幅值。结果:治疗前后2组ASIA残损分级比较,差异均无统计学意义。治疗后,2组ASIA运动评分、WISCIⅡ分级均较治疗前明显提高(P<0.05);观察组更优于对照组(P<0.05)。治疗后MEP检查结果显示,2组潜伏期与治疗前相比均明显缩短(P<0.01,0.05),且观察组优于对照组(P<0.05);治疗后2组波幅与治疗前相比均无显著统计学差异。结论:TMS联合经脊髓受损下端神经根磁刺激与康复训练可进一步促进不完全性SCI患者的脊髓运动功能的恢复,效果优于单纯康复训练。Objective： To observe the effects of transcranial magnetic stimulation （TMS） and the inferior spinal nerve roots injury region magnetic stimulation for the movement dysfunction of patients with incomplete spinal cord injury （SCI）. Methods： Forty cases of SCI with American Spinal Injury Association （ASIA） B-C level were assigned to the following groups： control group （n= 20）, receiving conventional rehabilitation therapy; observation group （n=20） receiving conventional rehabilitation therapy and magnetic stimulation therapy. Before and after treatment, ASIA grade, ASIA sports scores, and damaged spinal cord injury walk index Ⅱ （WISCI Ⅱ ） and motor evoked potentials （MEP） latency and amplitude were evaluated. Results： ASIA grade had no statistically significant difference between two groups before and after treatment. ASIA sports scores and WISCI Ⅱ grade in the two groups were sig nificantly improved after treatment （P〈0. 05）, and those in the observation group were better than the control group （P〈0.05）. MEP test results showed that the latency time in the two groups was shortened obviously after therapy （P〈0.01, or P〈0.05）, and observation group was superior to control group. The amplitude in the two groups had no statistically significant difference before and after treatment. Conclusion： TMS and the inferior spinal nerve roots injury region magnetic stimulation combined with conventional rehabilitation therapy can promote recovery of spinal movement function in patients with incomplete SCI, and the effect is better than simple rehabilitation therapy.

关 键 词：脊髓损伤 经颅磁刺激 运动功能 

分 类 号：R651.2[医药卫生—外科学] R49[医药卫生—临床医学]