文章摘要
章良翔,倪莹莹,邓丽霞,吕晓,赵春梅,马梦良,邱承尧,黎肖弟,黄丛萍.高频rTMS、脑仿生电及其序贯治疗脑外伤持续植物状态患者的临床观察[J].中国康复,2021,36(1):21-25
高频rTMS、脑仿生电及其序贯治疗脑外伤持续植物状态患者的临床观察
Clinical observation of high-frequency rTMS and biomimetic electroencephalography in the sequential treatment of patients with persistent vegetative state of brain injury
  
DOI:
中文关键词: 重复经颅磁刺激  脑仿生电刺激  持续植物状态  临床观察
英文关键词: repetitive transcranial magnetic stimulation  brain biomimetic electrical stimulation  persistent vegetative state  clinical observation
基金项目:广东省医学科学技术研究基金项目(B2017092)
作者单位
章良翔 广东三九脑科医院神经康复科广州 510510 
倪莹莹 广东三九脑科医院神经康复科广州 510510 
邓丽霞 广东三九脑科医院神经康复科广州 510510 
吕晓 广东三九脑科医院神经康复科广州 510510 
赵春梅 广东三九脑科医院神经康复科广州 510510 
马梦良 广东三九脑科医院神经康复科广州 510510 
邱承尧 广东三九脑科医院神经康复科广州 510510 
黎肖弟 广东三九脑科医院神经康复科广州 510510 
黄丛萍 广东三九脑科医院神经康复科广州 510510 
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中文摘要:
  目的:观察高频重复经颅磁刺激(rTMS)、脑仿生电刺激及其序贯治疗脑外伤持续植物状态(PVS)患者的临床疗效。方法:入组的脑外伤PVS患者予常规药物及康复治疗,并随机分为3组:rTMS组(24例),予高频rTMS治疗;脑仿生电组(23例),予脑仿生电治疗;rTMS与脑仿生电联合组(简称联合组,26例),先高频rTMS治疗后立即给脑仿生电刺激治疗。分别在治疗前、治疗6周后应用昏迷恢复量表修订版(CRS-R)评估患者意识状态,查脑电图(EEG)、脑干听觉诱发电位(BAEP)、体感诱发电位(SEP)。结果:治疗4周后,3组CRS-R评分较治疗前均有明显提高(均P<0.05),联合组CRS-R评分均高于脑仿生电组、rTMS组(均P<0.05)。治疗后,3组患者EEG、BEAP、SEP分级整体均较治疗前明显改善(均P<0.05),联合组较脑仿生电组、rTMS组明显改善(P<0.05)。治疗后,3组患者BEAP、SEP潜伏期较治疗前均有显著降低(P<0.05),联合组BEAP、SEP潜伏期均低于脑仿生电组、rTMS组(P<0.05)。结论:高频rTMS、脑仿生电刺激治疗均可以有效改善脑外伤PVS患者的意识及其脑电生理,且二者序贯治疗的效果优于单一治疗。
英文摘要:
  Objective: To investigate the clinical effect and mechanism of the sequential treatment of high-frequency repetitive transcranial magnetic stimulation (rTMS) and brain biomimetic electrical stimulation for the patients with persistent vegetative state (PVS) after brain injury. Methods: Patients with PVS after brain injury were given conventional treatment and randomly divided into three groups: rTMS group (24 cases) was treated by high frequency rTMS; brain biomimetic electrical stimulation group (23 cases) was treated by brain biomimetic electrical stimulation; the combined group (26 cases) was given rTMS combined with brain biomimetic electrical stimulation sequentially. Before and after 6 weeks of treatment, the CRS-R efficacy rating scale was used to evaluate the consciousness of all the patients; the changes of EEG, brainstem auditory evoked potential (BAEP) and somatosensory evoked potential (SEP) were recorded and compared. Results: After treatment of 4 weeks, CRS R scores, the EEG, BEAP and SEP levels in the three groups were improved significantly (P<0.05), more significantly in the combined group than in the brain biomimetic electrical stimulation group or rTMS group (P<0.05). All waves of BEAP, SEP in the three groups were decreased significantly (P<0.05), more significantly in the combined group than in the brain biomimetic electrical stimulation group or rTMS group (P<0.05).Conclusion: High-frequency rTMS or brain biomimetic electrical stimulation can improve the consciousness and brain electrophysiology of PVS patients after brain injury, and the sequential treatment was significantly superior to the single treatment.
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