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hrTMS联合MSS在重型颅脑损伤后慢性意识障碍患者的应用效果分析OACSTPCD

Analysis on application effect of hrTMS combined with MSS in patients with prolonged disorders of consciousness after severe traumatic brain injury

中文摘要英文摘要

目的 探讨高频重复经颅磁刺激(hrTMS)联合多感觉刺激疗法(MSS)在重型颅脑损伤(STBI)后慢性意识障碍(PDOC)患者的应用效果.方法 选取2020年3月至2022年11月该院收治的92例STBI引起的PDOC患者为研究对象,采用随机数字表均分为观察组(常规治疗+MSS+hrTMS)和对照组(常规治疗+MSS),每组46例.比较两组干预前、干预后2个月的脑电图检查结果、Glasgow昏迷量表(GCS)、残疾评分量表(DRS)、改良昏迷恢复量表(CRS-R),以及干预后的促醒有效率.结果 与干预前比较,干预后两组脑电图等级明显改善,且观察组优于对照组(P<0.05).与干预前比较,干预后两组GCS、CRS-R评分升高,DRS评分降低,且观察组GCS、CRS-R评分高于对照组,DRS评分低于对照组(P<0.05).干预后观察组促醒有效率高于对照组(76.1%vs.54.3%),差异有统计学意义(P<0.05).结论 hrTMS联合MSS改善STBI后PDOC患者的疗效较好.

Objective To investigate the effect of high-frequency repetitive transcranial magnetic stimu-lation(hrTMS)combined with multi-sensory stimulation(MSS)in the patients with prolonged disorders of consciousness(PDOC)after severe traumatic brain injury(STBI).Methods Ninety-two patients with PDOC caused by STBI in this hospital from March 2020 to November 2022 were selected as the study subjects and e-venly divided into the observation group(conventional treatment+MSS+hrTMS)and control group(con-ventional treatment+MSS)by adopting the random number table method,46 cases in each group.The elec-troencephalogram examination results,Glasgow Coma Scale(GCS),Disability Rating Scale(DRS)and Coma Recovery Scale-revised(CRS-R)scores before intervention and in 2 months after and intervention and the wake-promoting effective rates after intervention were compared between two groups.Results Compared with before intervention,the electroencephalogram(EEG)grade after intervention in the two groups was sig-nificantly improved,moreover the observation group was superior to the control group(P<0.05).Compared with before intervention,the GCS and CRS-R scores after intervention in the two groups were increased,the DRS score was decreased,moreover the GCS and CRS-R scores in the observation group were higher than those in the control group,while the DRS score was lower than that in the control group(P<0.05).After in-tervention,the wake-promoting effective rate in the observation group was higher than that in the control group(76.1%vs.54.3%),and the difference was statistically significant(P<0.05).Conclusion The hrT-MS combined with MSS has good effect for improving PDOC after STBI.

周青;孙娟

陆军军医大学第二附属医院疼痛康复医学科,重庆 400037

临床医学

慢性意识障碍;高频重复经颅磁刺激;多感觉刺激疗法;重型颅脑损伤;促醒疗效

prolonged disorders of consciousness;high-frequency repetitive transcranial magnetic stim-ulation;multi-sensory stimulation;severe traumatic brain injury;wake-promoting effect

《重庆医学》 2024 (001)

93-97 / 5

重庆市科卫联合医学科研项目(2022ZDXM002).

10.3969/j.issn.1671-8348.2024.01.019

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