双侧与单侧重复经颅磁刺激对痉挛型偏瘫脑瘫患儿运动功能影响的对比研究  

Comparative study on the effect of bilateral and unilateral repetitive transcranial magnetic stimulation on motor function of children with spastic hemiplegia cerebral palsy

作　　者：张杨萍 张丽华[1] 李雪梅[1] 汤敬华[1] ZHANG Yang-ping;ZHANG Li hua;LI Xue-mei;TANG Jing-hua(The Third Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang 154003 ,China)

机构地区：[1]佳木斯大学附属第三医院,黑龙江佳木斯154003

出　　处：《中国儿童保健杂志》2018年第5期533-536,共4页Chinese Journal of Child Health Care

基　　金：黑龙江省卫生厅课题(2013211)

摘　　要：目的观察高频结合低频重复经颅磁刺激(HF-rTMS和LF-rTMS)对痉挛型偏瘫脑瘫患儿运动功能的影响。方法将30例痉挛型偏瘫脑瘫患儿采用随机数字表法分为对照组和观察组,两组患儿均接受常规康复训练和受损伤半球的HF-rTMS,在此基础上对照组于未受损半球接受伪刺激,观察组接受LF-rTMS。试验前后使用粗大运动功能测试(GMFM-88)和精细运动能力测试量表(FMFM)进行评估。结果治疗8周后,两组患儿GMFM-88评分和FMFM评分均较治疗前有改善,差异具有统计学意义(P<0.05),且观察组患儿的改善效果优于对照组,差异具有统计学意义(P<0.05)。结论在常规康复治疗的基础上结合双侧rTMS(BL-rTMS)模式比结合单侧刺激模式更能改善痉挛型偏瘫脑瘫患儿的上肢运动功能和粗大运动功能。Objective To observe the effect of high-frequency combined with low-frequency repetitive transcranial magnetic stimulation （HF-rTMS and LF-rTMS） on the motor function of children with spastic cerebral palsy. Methods A total of 30 patients with spastic hemiplegic cerebral palsy were divided into two groups using a random number table method. Both groups received routine rehabilitation training and HF-rTMS on the affected hemisphere. In addition, the control group received pseudo-stimulation on the unaffected hemisphere and the observation group received LF-rTMS. Gross Motor Function Measure（GMFM）-88 and fine motor function measure （FMFM） were used to evaluate motor function before and after the session. Results Scores of GMFM-88 and FMFM in two groups were higher after the intervention with significant difference（P〈0.05）, especially in the observation group. Conclusion Conventional rehabilitation therapy combined with bilateral rTMS model can better improve the upper limb motor function and gross motor function of children with spastic hemiplegia cerebral palsy than the unilateral stimulation model.

关 键 词：重复经颅磁刺激 痉挛型偏瘫脑瘫 精细运动 粗大运动 

分 类 号：R179[医药卫生—妇幼卫生保健]