电刺激联合重复经颅磁刺激对脑卒中患者偏侧忽略的影响  

Effect of electrical stimulation combined with repetitive transcranial magnetic stimulation on unilateral neglect in stroke patients

作　　者：李琛 段维维 刘佳[1] LI Chen;DUAN Wei-Wei;LIU Jia(Department of Rehablitation Medicine,Hunan Provincial Pepole’s Hospital(The First Affiliated Hospital of Hunan Normal University),Changsha,Hunan 410000,China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)康复医学科,湖南长沙410000

出　　处：《国际神经病学神经外科学杂志》2020年第2期132-135,共4页Journal of International Neurology and Neurosurgery

摘　　要：目的观察功能性电刺激联合重复经颅磁刺激(r TMS)对脑卒中患者偏侧忽略的影响。方法 40例脑卒中后偏侧忽略患者被随机分为观察组和对照组,每组各20例。2组患者均接受常规康复治疗和r TMS,观察组加以功能性电刺激治疗。采用行为忽略学测试(BIT)、凯瑟琳博格量表(CBS)、改良巴氏指数(MBI)及Fugl-Meyer上肢运动评定(FMA-UE)对治疗前后的偏侧忽略进行评定。结果治疗前,2组患者在年龄、性别、病程、卒中类型及MMSE评分比较,差异无统计学意义(P> 0. 05)。治疗后,观察组在BIT(93. 7±6. 5)、CBS(13. 0±2. 6)、MBI(43. 5±4. 0)及FMA-UE(26. 6±5. 2)显著改善,差异有统计学意义(P <0. 05);对照组在BIT(80. 3±6. 9)、CBS(16. 1±3. 6)、MBI(37. 1±2. 4)及FMA-UE(18. 8±4. 1]改善,差异有统计学意义(P <0. 05)。观察组各项评分均优于对照组,差异有统计学意义(P <0. 05)。结论功能性电刺激联合r TMS能更有效改善脑卒中偏侧忽略,可作为偏侧忽略的联合治疗策略。Objective To investigate the effect of functional electrical stimulation combined with repetitive transcranial magnetic stimulation(rTMS)on unilateral neglect in stroke patients.Methods Forty stroke survivors with unilateral neglect were randomly divided into experimental group(n=20)and control group(n=20).Both groups were given conventional rehabilitation treatment and rTMS,and the experimental group was given functional electrical stimulation additionally.The Behavioral Inattention Test(BIT),Catherine Bergego Scale(CBS),Modified Barthel Index(MBI),and Fugl-Meyer Assessment-Upper Extremity(FMA-UE)were used to assess the unilateral neglect before and after treatment.Results Before treatment,there were no significant differences in age,sex,course of disease,type of stroke,and Mini-Mental State Examination score between the two groups(P>0.05).After treatment,both experimental and control groups showed significant improvements in BIT score(93.7±6.5,80.3±6.9),CBS score(13.0±2.6,16.1±3.6),MBI score(43.5±4.0,37.1±2.4),and FMA-UE score(26.6±5.2,18.8±4.1).The experimental group had significantly better scores than the control group(P<0.05).Conclusions Functional electrical stimulation combined with rTMS is more effective than rTMS alone in improving unilateral neglect after stroke,and can be used as a combined treatment strategy for unilateral neglect.

关 键 词：脑卒中 偏侧忽略 功能性电刺激 重复经颅磁刺激 

分 类 号：R743.3[医药卫生—神经病学与精神病学]