重复经颅磁刺激在改善中型颅脑损伤后认知功能障碍的应用价值  

Application value of rTMS in improving cognitive function in patients with cognitive impairment after moderate traumatic brain injury

作　　者：苗静静 张丹丹 楚文欠 MIAO Jing-jing;ZHANG Dan-dan;CHU Wen-qian(Department of Neurosurgery,Zhengzhou Central Hospital,Zhengzhou 450000,Henan,China)

机构地区：[1]郑州市中心医院神经外科,河南郑州450000

出　　处：《青岛医药卫生》2022年第4期254-257,共4页Qingdao Medical Journal

摘　　要：目的探讨重复经颅磁刺激(Repetitive transcranial magnetic stimulation,rTMS)对中型颅脑损伤后认知功能障碍患者的应用效果。方法选择本院2020年1月至2020年12月收治的中型颅脑损伤后认知功能障碍患者95例,根据治疗方法不同分为对照组和观察组,对照组(n=47)给予认知功能训练、高压氧等基础治疗,观察组(n=48)在对照组基础上增加左前额叶背外侧区15Hz rTMS,4周后,对比两组患者认知功能、脑白质区结构和功能水平、脑损伤标志物水平。结果治疗后,观察组中文版神经行为认知状况测试量表(NCSE)和简易精神状态检查量表(MMSE)评分均高于对照组(P<0.05),胼胝体压部、膝部、体部、左前侧放射冠、右前侧放射冠和左侧上纵束各向异性分数(FA)值均高于对照组(P<0.05),血清神经元特异性烯醇化酶(NSE)、蛋白S100B(S100B)水平均低于对照组(P<0.05)。结论左前额叶背外侧区15Hz rTMS能够有效改善中型颅脑损伤后认知功能障碍患者认知功能,促进脑白质区结构和功能水平恢复,降低脑损伤标志物水平,具有临床推广价值。Objective To study the application value ofrepetitive transcranial magnetic stimulation(rTMS)in improving cognitive function in patients with cognitive impairment after moderate traumatic brain injury.Methods A total of 95 patients with cognitive impairment after moderate craniocerebral injury from January 2020 to December 2020 in our hospital were selected and divided into the control group and observation group according to different treatments.The control group(n=47)was given cognitive function training,hyperbaric oxygen,the observation group(n=48)was given 15Hz rTMS in the dorsolateral area of the left prefrontal lobe on the basis of the control group.Results After treatment,the scores of Chinese version of Neurobehavioral Cognitive Status Test(NCSE)and Mini Mental State Examination(MMSE)in the observation group were higher than those in the control group(P<0.05).The knee,body,left anterior corona radiata,right anterior corona radiata and left superior longitudinal beam anisotropy fraction(FA)values were higher than those in the control group(P<0.05).The level of Neuron specific enolase(NSE),protein S100B(S100B)were lower than those of the control group(P<0.05).Conclusion The 15Hz rTMS in the dorsolateral area of the left prefrontal lobe has an exact effect on patients with cognitive impairment after moderate traumatic brain injury and has the value of clinical promotion.

关 键 词：重复经颅磁刺激 认知功能 中型颅脑损伤 左前额叶背外侧区 

分 类 号：R651.15[医药卫生—外科学]