低频重复经颅磁刺激辅助手术治疗对重型颅脑损伤患者炎性因子、血流动力学及预后的影响

Effects of low-frequency repetitive transcranial magnetic stimulation-assisted surgery on inflammatory factors,hemodynamics and prognosis in patients with severe traumatic brain injury

目的分析低频重复经颅磁刺激辅助手术治疗对重型颅脑损伤患者炎性因子、血流动力学及预后的影响。方法选取2020年5月至2022年11月于空军军医大学第二附属医院唐都医院神经外科治疗的重型颅脑损伤患者132例,根据治疗方案分为对照组(大骨瓣减压手术)64例与观察组(低频重复经颅磁刺激辅助大骨瓣减压手术)68例。对比两组炎性因子[白介素-4(IL-4)、白介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)]、血流动力学[双侧颈内动脉搏动指数(PI)、收缩期最大血流速度(Vs)和平均血流速度(Vm)]、预后情况及并发症发生率。结果两组治疗后IL-4、IL-6及TNF-α水平均显著下降,且观察组IL-4、IL-6及TNF-α水平均低于对照组,差异有统计学意义(P<0.05)。观察组PI水平低于对照组,Vs、Vm水平高于对照组,差异有统计学意义(P<0.05)。观察组预后良好率高于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论低频重复经颅磁刺激辅助手术治疗对重型颅脑损伤患者炎性因子起到改善作用,可有效调节大脑血流速度与血流量,降低脑血流阻力,利于改善患者预后。

Objective To analyze the effects of low-frequency repetitive transcranial magnetic stimulation-assisted surgery on inflammatory factors,hemodynamics,and prognosis in patients with severe traumatic brain injury.Methods 132 patients with severe craniocerebral injury who were treated in the Neurosurgery Department of Tangdu Hospital,the Second Affiliated Hospital of Air Force Military Medical University from May 2020 to November 2022 were selected,and according to the treatment plan,they were divided into the control group(large bone craniectomy)of 64 cases and the observation group(low-frequency repetitive transcranial magnetic stimulation assisted large bone craniectomy)68 cases.The inflammatory factors[Interleukin-4(IL-4),Interleukin-6(IL-6)and tumor necrosis factor-alpha(TNF-α)],hemodynamics[bilateral internal carotid artery pulsation index(PI),systolic maximum blood flow velocity(Vs)and mean blood flow velocity(Vm)],prognosis and complication rate between the two groups were compared.Results The levels of IL-4,IL-6 and TNF-αin two groups were significantly decreased after treatment,and the levels of IL-4,IL-6 and TNF-αin the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).The PI levels in the observation group were lower than those in the control group,while the Vs and Vm levels in the observation group were higher than those in the control group,the difference was statistically significant(P<0.05).The good prognosis rate of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).The total incidence in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Low-frequency repetitive transcranial magnetic stimulation-assisted surgery can improve inflammatory factors in patients with severe traumatic brain injury,can effectively regulate cerebral blood flow velocity and blood flow,reduce cerebral blood flow resistance,and help improve prognosis patients.