经颅磁刺激联合高压氧治疗腔隙性脑梗死认知损伤的临床研究

Clinical Study of Transcranial Magnetic Stimulation Combined with Hyperbaric Oxygen in the Treatment of Cognitive Impairment in Lacunar Cerebral Infarction

目的探讨经颅磁刺激(rTMS)联合高压氧治疗腔隙性脑梗死伴认知损伤的临床疗效。方法选取2018年8月-2020年7月安徽医科大学附属安庆医院神经内科收治的90例门诊或住院腔隙性脑梗死后认知功能障碍,但未达到痴呆诊断标准的患者,随机分为rTMS治疗组、高压氧治疗组和联合治疗组,各30例。三组均予基础治疗,rTMS治疗组给予rTMS治疗,高压氧治疗组患者予以高压氧治疗,联合治疗组予以rTMS联合高压氧治疗。比较三组患者总有效率和P300潜伏期及波幅。结果联合治疗组总有效率高于高压氧治疗组和rTMS治疗组,差异有统计学意义(P<0.05);三组潜伏期均低于治疗前,且联合治疗组低于rTMS治疗组和高压氧治疗组,差异有统计学意义(P<0.05);三组波幅均高于治疗前,且联合治疗组高于rTMS治疗组和高压氧治疗组,差异有统计学意义(P<0.05)。结论经颅磁刺激联合高压氧治疗可改善腔隙性脑梗死患者的认知损伤,从而改善其生活质量。

Objective To explore the clinical efficacy of transcranial magnetic stimulation combined with hyperbaric oxygen in the treatment of lacunar cerebral infarction with cognitive impairment.Methods From August 2018 to July 2020,90 patients with cognitive dysfunction after outpatient or inpatient lacunar infarction but who did not meet the diagnostic criteria for dementia were selected from the Department of Neurology,Anqing Hospital Affiliated to Anhui Medical University were randomly divided into rTMS treatment group,hyperbaric oxygen treatment group and combined treatment group,with 30 cases in each group.All three groups were given basic treatment,rTMS treatment group was given rTMS treatment,hyperbaric oxygen treatment group was given hyperbaric oxygen treatment,combined treatment group was given rTMS combined with hyperbaric oxygen treatment.The total effective rate and P300 latency and amplitude were compared among the three groups.Results The total effective rate of the combined treatment group was higher than that of the hyperbaric oxygen treatment group and the rTMS treatment group,and the difference was statistically significant(P<0.05).The incubation period of the three groups was lower than that before treatment,and the combined treatment group was lower than that of rTMS treatment group and hyperbaric oxygen treatment group,the difference was statistically significant(P<0.05);the amplitude was higher than that before treatment,the combined treatment group was higher than that of rTMS treatment group and hyperbaric oxygen treatment group,and the difference was statistically significant(P<0.05).Conclusion Transcranial magnetic stimulation combined with hyperbaric oxygen therapy can improve the cognitive impairment of patients with lacunar cerebral infarction,thereby improving their quality of life.