重复经颅磁刺激联合高压氧辅助治疗缺血性脑卒中的临床效果观察

Observation of clinical effect of repetitive transcranial magnetic stimulation combined with hyperbaric oxygen in the assisted treatment of ischemic stroke

目的观察重复经颅磁刺激(rTMS)联合高压氧辅助治疗缺血性脑卒中的临床效果。方法选取80例缺血性脑卒中患者,采用随机数字表法分为对照组(n=40)和研究组(n=40)。对照组在常规治疗的基础上采用伪刺激并高压氧治疗,研究组在常规治疗的基础上采用间歇性θ短阵脉冲刺激(iTBS)模式的rTMS联合高压氧辅助治疗。比较两组患者临床疗效、治疗前与治疗2个疗程后美国国立卫生研究院卒中量表(NIHSS)评分及日常生活能力量表(ADL)评分;随访6个月,比较两组患者的并发症发生情况。结果研究组患者治疗总有效率为92.50%,高于对照组的75.00%(P<0.05)。治疗2个疗程后,两组患者的NIHSS评分均降低,ADL评分升高,且研究组NIHSS评分低于对照组,ADL评分高于对照组(均P<0.05)。观察组随访率为97.50%,高于对照组的92.50%,但两组比较差异无统计学意义(P>0.05)。观察组并发症发生率为10.00%,显著低于对照组的27.50%(P<0.05)。结论rTMS联合高压氧治疗缺血性脑卒中可改善患者临床症状,提高其生活能力,且效果显著,值得推广。

Objective To observe the clinical effect of repetitive transcranial magnetic stimulation(rTMS)combined with hyperbaric oxygen in the assisted treatment of ischemic stroke.Methods A total of 80 patients with ischemic stroke were selected and divided into control group(n=40)and study group(n=40)by the random number table method.On the basis of conventional treatment,the control group was treated with pseudo stimulation combined with hyperbaric oxygen,and the study group was treated with rTMS in intermittent Theta burst stimulation(iTBS)mode combined with hyperbaric oxygen.The clinical efficacy,the National Institutes of Health Stroke Scale(NIHSS)scores,and activities of daily living(ADL)scores before and after 2 treatment courses were compared between the two groups;after 6 months of follow-up,the prevalence of complications was compared between the two groups.Results The total effective rate of the study group was 92.50%,which was higher than 75.00%of the control group(P<0.05).After two courses of treatment,the NIHSS scores of the two groups decreased,whereas the ADL scores increased,and the study group yielded lower NIHSS score and higher ADL score as compared with the control group(all P<0.05).The follow-up rate of the study group was 97.50%,which was higher than 92.50%of the control group,but there was no statistically significant difference between the two groups(P>0.05).The incidence of complications in the study group was 10.00%,which was significantly lower than 27.50%in the control group(P<0.05).Conclusion rTMS combined with hyperbaric oxygen in the treatment of ischemic stroke can significantly improve the clinical symptoms of patients,increase their living ability,with a significant effect,which is worthy of promotion.