经颅磁刺激与作业疗法对脑卒中患者的疗效  

Effect of Transcranial Magnetic Stimulation and Occupational Therapy on Stroke Patients

作　　者：李娴 LI Xian(Department of Rehabilitation Medicine,Nanyang Nanshi Hospital,Nanyang 473000,China)

机构地区：[1]南阳南石医院康复医学科,河南南阳473000

出　　处：《河南医学研究》2025年第1期100-103,共4页Henan Medical Research

摘　　要：目的探究低频重复经颅磁刺激(rTMS)结合作业治疗在脑卒中导致上肢运动障碍患者中的疗效。方法纳入2022年1月至2023年5月于南阳南石医院收治的100例脑卒中上肢瘫痪患者作为观察对象,收集其临床资料进行回顾性分析。其中50例患者仅接受作业疗法(对照组),余下患者在作业疗法的基础上联合rTMS治疗(观察组)。监测两组患者实施治疗效果并对其治疗前后的上肢功能评分、脑血流动力学参数以及生活质量评分进行对比分析,同时记录并统计不良事件的发生情况。结果在临床疗效方面,相较于对照组观察组更优且不良反应发生率较低(P<0.05)。在血浆黏性、纤维蛋白原水平以及血小板聚集方面,相较于对照组,观察组经治疗后的下降幅度较显著(P<0.05)。观察组治疗后FMA评分、SF-36评分较对照组偏高,DASH评分偏低(P<0.05)。结论rTMS联合作业疗法可有效改善脑卒中上肢瘫痪患者的上肢功能和脑血流动力学指标,提高生活质量,且安全性较高。Objective To investigate the effectiveness of low frequency repetitive transcranial magnetic stimulation(rTMS)and occupational therapy in patients with upper limb dyskinesia due to stroke.Methods A total of 100 patients with upper limb paralysis after stroke admitted to Nanyang Nanshi Hospital from January 2022 to May 2023 were included as the observation objects,and their clinical data were collected and analyzed retrospectively.Among them,50 patients only received occupational therapy(control group),and the rest were treated with rTMS on the basis of occupational therapy(observation group).The therapeutic effects of the two groups were observed,and the differences of cerebral hemodynamics,upper limb function score and quality of life score between the two groups before and after treatment were compared,and the incidence of adverse reactions was counted.Results In terms of clinical efficacy,compared with the control group,the observation group was more favourable and the incidence of adverse events was lower(P<0.05).Plasma viscosity,fibrinogen concentration and platelet aggregation decreased more significantly in the observation group compared with the control group(P<0.05).FMA and SF-36 scores were higher and DASH score was lower in the observation group after treatment compared with the control group(P<0.05).Conclusion rTMS combined with occupational therapy can effectively improve the upper limb function and cerebral hemodynamic indexes of stroke patients with upper limb paralysis,and improve the quality of life,with high safety.

关 键 词：脑卒中 上肢瘫痪 重复经颅磁刺激 作业疗法 回顾性研究 

分 类 号：R493[医药卫生—康复医学]