hrTMS联合MSS在重型颅脑损伤后慢性意识障碍患者的应用效果分析

Analysis on application effect of hrTMS combined with MSS in patients with prolonged disorders of consciousness after severe traumatic brain injury

目的探讨高频重复经颅磁刺激(hrTMS)联合多感觉刺激疗法(MSS)在重型颅脑损伤(STBI)后慢性意识障碍(PDOC)患者的应用效果。方法选取2020年3月至2022年11月该院收治的92例STBI引起的PDOC患者为研究对象,采用随机数字表均分为观察组(常规治疗+MSS+hrTMS)和对照组(常规治疗+MSS),每组46例。比较两组干预前、干预后2个月的脑电图检查结果、Glasgow昏迷量表(GCS)、残疾评分量表(DRS)、改良昏迷恢复量表(CRS-R),以及干预后的促醒有效率。结果与干预前比较,干预后两组脑电图等级明显改善,且观察组优于对照组(P<0.05)。与干预前比较,干预后两组GCS、CRS-R评分升高,DRS评分降低,且观察组GCS、CRS-R评分高于对照组,DRS评分低于对照组(P<0.05)。干预后观察组促醒有效率高于对照组(76.1%vs.54.3%),差异有统计学意义(P<0.05)。结论hrTMS联合MSS改善STBI后PDOC患者的疗效较好。

Objective To investigate the effect of high-frequency repetitive transcranial magnetic stimulation(hrTMS)combined with multi-sensory stimulation(MSS)in the patients with prolonged disorders of consciousness(PDOC)after severe traumatic brain injury(STBI).Methods Ninety-two patients with PDOC caused by STBI in this hospital from March 2020 to November 2022 were selected as the study subjects and evenly divided into the observation group(conventional treatment+MSS+hrTMS)and control group(conventional treatment+MSS)by adopting the random number table method,46 cases in each group.The electroencephalogram examination results,Glasgow Coma Scale(GCS),Disability Rating Scale(DRS)and Coma Recovery Scale-revised(CRS-R)scores before intervention and in 2 months after and intervention and the wake-promoting effective rates after intervention were compared between two groups.Results Compared with before intervention,the electroencephalogram(EEG)grade after intervention in the two groups was significantly improved,moreover the observation group was superior to the control group(P<0.05).Compared with before intervention,the GCS and CRS-R scores after intervention in the two groups were increased,the DRS score was decreased,moreover the GCS and CRS-R scores in the observation group were higher than those in the control group,while the DRS score was lower than that in the control group(P<0.05).After intervention,the wake-promoting effective rate in the observation group was higher than that in the control group(76.1%vs.54.3%),and the difference was statistically significant(P<0.05).Conclusion The hrTMS combined with MSS has good effect for improving PDOC after STBI.