重复经颅磁刺激在无骨折脱位型脊髓损伤中的疗效观察  

Application of repeated transcranial magnetic stimulation in non-fracture and dislocation spinal cord injury

作　　者：赵东升 别小华 薛俊刚 Zhao Dongsheng(Department of Neurosurgery,Xi'an Red Cross Hospital,Xi'an 710054,China)

机构地区：[1]西安市红会医院神经外科,710054

出　　处：《美中国际创伤杂志》2024年第3期23-26,53,共5页U.S.Chinese International Journal of Traumatology

摘　　要：目的:探讨重复经颅磁刺激(rTMS)在无骨折脱位型脊髓损伤(SCIWORA)中的治疗效果。方法:回顾性分析我院自2019年1月-2022年10月收治的122例SCIWORA患者,随机分为对照组60例,治疗组62例。对照组接受常规治疗及康复治疗;治疗组在此基础上加用TMS治疗。两组患者在治疗前后比较ASIA残损分级、ASIA运动评分、并发症发生率。结果:治疗前,两组患者数量、年龄、损伤部位患者数量、ASIA运动评分对比均无明显差异(P>0.05);治疗60d后,ASIA运动评分较治疗前均有提高,治疗组更优于对照组(P<0.05)。治疗组经治疗后感觉平面均有下移,12例仍需导尿,其余可自行排尿或按压腹部即可排尿,8例便秘患者需长期用药物辅助排便,其余可自行或按摩后解大便。肺部感染者均治愈,无深静脉血栓,无压疮,肌肉萎缩4例。对照组经治疗后感觉平面有42例患者下移,18例患者感觉平面维持原状,42例仍需导尿,其余需按压腹部即可排尿,47例便秘患者需长期用药物辅助排便,其余可自行或按摩后解大便。6例肺部感染反复发生,21例深静脉血栓,4例压疮,肌肉萎缩42例。结论:rTMS联合传统治疗可明显改善SCIWORA患者的运动、感觉、二便功能,效果优于传统治疗。Objective:To investigate the effects of the repeated transcranial magnetic stimulation(rTMS)in nonfracture and dislocation spinal cord injury.Methods:122 cases of SCIWORAwith American Spinal Injury Association(ASIA)A-Dlevel were assigned to the following groups:control group(n=6O),receiving conventional rehabilitation therapy;treatment group(n=62),receiving conventional rehabilitation therapy and magnetic stimulation therapy.Before and after treatment,ASIA grade,ASIA sports scores were evaluated.Results:Before treatment,there was no statistically significant difference between the two groups in the number of patients,age,number of patients with injury site and ASIA sports score(P<0.05).After 60 days of treatment,the ASIA motor score was higher than that before treatment,and the treatment group was better than the control group.In the treatment group,the sensory plane of all patients moved down after treatment,12 patients still needed catheterization,the rest could urinate by themselves or by pressing the abdomen,8 patients with constipation needed long-term drug-assisted defecation,all lung infections were cured,the rest could defecate by themselves or by massage.There were no deep vein thrombosis,pressure sore,4 cases with muscle atrophy.In the control group,42 patients moved down the sensory plane,18 patients kept the sensory plane unchanged.42 patients still needed catheterization,the rest needed to press the abdomen to urinate.47 patients with constipation needed long-term drug-assisted defecation,the rest could defecate by themselves or massage.There were 6 cases of recurrent pulmonary infection,21 cases of deep vein thrombosis,4 cases of pressure sore and 42 cases of muscle atrophy.Conclusion:rTMS combined with traditional treatment can significantly improve the movement,sensation and defecation function of patients with spinal cord injury without fracture and dislocation,and the effect is better than that of traditional treatment.

关 键 词：脊髓损伤 重复经颅磁刺激 瘫痪 大小便功能障碍 

分 类 号：R47[医药卫生—护理学]