重复经颅磁刺激在脑干出血昏迷患者治疗中的应用效果

Application Effect of Repetive Transcranial Magnetic Stimulation in the Treatment of Coma Patients with Cerebral Stem Hemorrhage

背景降低脑干出血病死率、提高患者生存质量一直是神经外科医生面临的难题,故探寻脑干出血治疗方法非常重要。目的探讨重复经颅磁刺激(rTMS)在脑干出血昏迷患者治疗中的应用效果。方法选取2017年10月—2019年1月西安市红会医院收治的使用rTMS治疗的脑干出血昏迷患者15例作为治疗组,另选取本院2000年1月—2017年9月收治的未使用rTMS治疗的脑干出血昏迷患者42例作为对照组。比较两组患者呼吸机使用时间、入院后3~6个月预后〔格拉斯哥预后量表(GOS)评分,死亡和存活情况〕、肺部感染发生及治愈情况。结果治疗组患者呼吸机使用时间长于对照组,GOS评分高于对照组,病死率低于对照组(P<0.05)。治疗组患者肺部感染发生率低于对照组,肺部感染治愈率高于对照组(P<0.05)。结论尽早使用rTMS利于减少脑干出血昏迷患者呼吸机使用时间及肺部感染发生风险,提高肺部感染治愈率,进而改善患者预后。

Background Reducing the death rate of cerebral stem hemorrhage and improving the quality of life of patients have always been a difficult problem for neurosurgeons,therefore,it is very important to explore the treatment of cerebral stem hemorrhage.Objective To investigate the application effect of repetive transcranial magnetic stimulation(rTMS)in the treatment of coma patients with cerebral stem hemorrhage.Methods 15 coma patients with cerebral stem hemorrhage treated by rTMS in Xi'an Honghui Hospital from October 2017 to January 2019 were selected as the treatment group,and 42 coma patients with cerebral stem hemorrhage without treated by rTMS from January 2000 to September 2017 were selected as the control group.The ventilator use time,prognosis〔Glasgow Outcome Scale(GOS)score,death and survival〕of 3-6 months after admission,occurrence and cure of pulmonary infection were compared between the two groups.Results The ventilator use time of the treatment group was longer than that of the control group,the GOS score was higher than that of the control group,and the mortality rate was lower than that of the control group(P<0.05).The incidence of pulmonary infection in the treatment group was lower than that in the control group,and the cure rate of pulmonary infection in the treatment group was higher than that in the control group(P<0.05).Conclusion Early use of rTMS can reduce the ventilator use time and the risk of pulmonary infection in coma patients with cerebral stem hemorrhage,improve the cure rate of pulmonary infection,and then improve the prognosis of patients.