重复经颅磁刺激联合星状神经节阻滞对脑梗死后运动性失语的作用

Effect of Repetitive Transcranial Magnetic Stimulation Combined with Stellate Ganglion Block on Motor Aphasia After Cerebral Infarction

目的探讨重复经颅磁刺激(rTMS)联合星状神经节阻滞(SGB)对脑梗死后运动性失语的作用。方法选取2018年1月至2019年6月于郑州大学第二附属医院神经康复科治疗的124例脑梗死后运动性失语患者。根据治疗方法将患者分为对照组(62例)和观察组(62例)。在常规药物治疗的基础上,给予对照组患者rTMS治疗,给予观察组患者rTMS联合SGB治疗。分别于治疗前后采用西方失语成套测验(WAB)评价患者的语言能力,包括自发语言、口语理解、命名和复述功能。分别于治疗前后采用日常生活活动量表(ADL)评估患者的日常生活活动能力,用Barthel指数表示。比较两组疗效及治疗前后失语指数。结果观察组治疗总有效率[90.32%(56/62)]较对照组[75.81%(47/62)]高(P<0.05)。治疗后,两组失语指数、语言能力(自发语言、口语理解、命名和复述功能)评分及Barthel指数均高于治疗前,观察组失语指数、语言能力(自发语言、口语理解、命名和复述功能)评分及Barthel指数高于对照组(P<0.05)。结论rTMS联合SGB有助于更好地改善脑梗死后运动性失语患者的语言功能,从而提高患者的日常生活能力。

Objective To explore the effect of repetitive transcranial magnetic stimulation(rTMS)combined with stellate ganglion block(SGB)on motor aphasia after cerebral infarction.Methods A total of 124 patients with motor aphasia after cerebral infarction were treated in the Department of Neurorehabilitation in the Second Affiliated Hospital of Zhengzhou University from January 2018 to June 2019.According to the treatment methods,the patients were divided into control group(62 cases)and observation group(62 cases).On the basis of conventional drug treatment,the patients in control group were given rTMS treatment,and the patients in observation group were given rTMS combined with SGB treatment.Western aphasia battery(WAB)was used to evaluate patients’language ability before and after treatment,including spontaneous language,oral understanding,naming and retelling.Activity of daily living scale(ADL)was used to evaluate patients’activity of daily living before and after treatment,which was expressed by Barthel index.The efficacy and aphasia index before and after treatment were compared between the two groups.Results The total effective rates in control group and observation group were 75.81%(47/62)and 90.32%(56/62),respectively.The total effective rate in observation group was higher than that in control group(P<0.05).After treatment,the scores of aphasia index,the ability of language(spontaneous language,oral understanding,naming and retelling)and Barthel index of the two groups were higher than those before treatment,and the scores of aphasia index,the ability of language(spontaneous language,oral understanding,naming and retelling)and Barthel index in observation group were higher than those in control group(P<0.05).Conclusion rTMS combined with SGB could improve the language function of patients with motor aphasia after cerebral infarction,so as to improve their daily living ability.