高频重复经颅磁刺激联合常规康复治疗对重症颅脑损伤意识障碍患者的效果观察OA

Objective To investigate the effect of high-frequency repetitive transcranial magnetic stimulation(rTMS)combined with routine rehabilitation therapy in patients with disorders of consciousness(DOC)after severe traumatic brain injury.Methods Patients with DOC after severe traumatic brain injury admitted to our hospital from April 2024 to October 2025 were enrolled and divided into two groups according to whether they received high-frequency rTMS treatment.A total of 70 patients with balanced baseline data were matched using the 1∶1 propensity score matching method,with 35 cases in each group.The therapeutic effects,as well as the cerebral metabolic indicators[N-acetylaspartate(NAA)/creatine(Cr),choline complex(Cho)/Cr],consciousness status[Glasgow Coma Scale(GCS),Coma Recovery Scale-Revised(CRS-R)],neuroelectrophysiological grades[electroencephalogram(EEG)grade,brainstem auditory evoked potential(BAEP)grade,upper limb somatosensory evoked potential(SSEP)grade],and cerebral blood flow velocity indicators[mean blood flow velocities of middle cerebral artery(MCA)and basilar artery(BA)]before and after treatment were compared between the two groups.Results Compared with the control group,the total effective rate of treatment in the observation group was higher(P<0.05).There were no significant differences in all indicators between the two groups before treatment(P>0.05).Compared with the control group,the observation group had higher NAA/Cr ratio,mean blood flow velocities of MCA and BA,GCS score and CRS-R score,lower Cho/Cr ratio,and better EEG,BAEP and SSEP grades after treatment(P<0.05).Conclusions High-frequency rTMS combined with routine rehabilitation therapy has a better effect on patients with DOC after severe traumatic brain injury.It can improve cerebral metabolism and cerebral blood flow velocity,restore neuroelectrophysiological function,thereby improving the consciousness status of patients and enhancing the therapeutic effect.