重复经颅磁刺激对脑卒中患者神经功能恢复及运动诱发电位的影响

Effect of repetitive transcranial magnetic stimulation on nerve function recovery and motor evoked potentials of patients with stroke

目的探讨重复经颅磁刺激(r TMS)对脑卒中患者神经功能恢复及运动诱发电位的影响。方法纳入焦作市人民医院2020-05—2021-08收治的60例脑卒中患者,分为对照组30例和研究组30例。2组均行脑卒中常规治疗,对照组用常规Bobath技术治疗,研究组在常规Bobath技术治疗的基础上采用rTMS治疗,应用NIHSS评分、改良Barthel指数(MBI)比较2组患者治疗前后神经功能恢复情况、日常生活能力和运动诱发电位。结果2组治疗后2、4周NIHSS评分均下降,研究组NIHSS评分明显低于对照组[2周:(13.26±2.09)分vs(15.51±2.84)分;4周:(10.45±2.36)分vs(12.25±3.43)分],差异均有统计学意义(P<0.05)。治疗后研究组MBI评分高于对照组[(73.56±16.36)分vs(57.22±13.31)分],差异有统计学意义(t=4.27,P<0.05)。2组治疗后运动诱发电位(MEP)潜伏期、中枢运动传导时间(CMCT)均低于治疗前,差异有统计学意义(P<0.05)。研究组MEP潜伏期明显低于对照组[(26.06±2.30)ms vs(28.09±2.24)ms],波幅明显大于对照组[(1.42±0.40)mV vs(1.16±0.22)mV],差异均有统计学意义(P<0.05)。结论rTMS治疗脑卒中有效率较高,能够促进患者神经功能的恢复,明显改善运动诱发电位。

Objective To explore the effect of repetitive transcranial magnetic stimulation(rTMS)on nerve function recovery and motor evoked potentials of patients with stroke.Methods A total of 60 stroke patients admitted to Jiaozuo People’s Hospital from May 2020 to August 2021 were divided into study group(30 cases)and control group(30 cases).The patients in the two groups received conventional treatment for stroke.Conventional Bobath technique was used in the control group,and conventional Bobath technique and rTMS treatment were used in the study group.The NIHSS score and modified Barthel Index(MBI)were used to compare the recovery of nerve function,daily living ability and motor evoked potential before and after treatment in the two groups.Results The NIHSS scores of both groups decreased at 2 and 4 weeks after treatment,which of study group were significantly lower than those of control group(2 weeks:(13.26±2.09)points vs(15.51±2.84)points;4 weeks:(10.45±2.36)points vs(12.25±3.43)points),there were significant differences on the NIHSS scores in both groups(P<0.05).After treatment,the MBI score of the study group was higher than that of the control group((73.56±16.36)points vs(57.22±13.31)points),and there was significant difference on MBI scores in both groups(P<0.05).After treatment,motor evoked potential(MEP)latency and central motor conduction time(CMCT)in both groups were lower than those before treatment,and the difference was statistically significant(P<0.05).Compared with the control group,the MEP latency of the study group was significantly lower((26.06±2.30)ms vs(28.09±2.24)ms),and the amplitude was significantly greater((1.42±0.40)mV vs(1.16±0.22)mV),the differences were statistically significant(P<0.05).Conclusion rTMS is highly effective in the treatment of stroke,can promote the recovery of the patient’s nerve function,and significantly improve the motor evoked potentials.