健侧重复经颅磁刺激对脑外伤患者记忆和生活质量的影响

摘要

目的 观察健侧低频重复经颅磁刺激(rTMS)对脑外伤患者的记忆和生活质量的影响.方法 2013年9月至2015年6月,本院60例脑外伤后记忆功能障碍患者,随机分为对照组(n=30)和观察组(n=30).两组均给予常规神经外科治疗.观察组在此基础上予以健侧低频rTMS治疗,每天治疗1次,每周连续治疗5 d,休息2 d,共治疗4周.观察两组患者治疗前后Rivermead行为记忆测验(RBMT)和世界卫生组织生活质量测定简表(WHOQOL-BREF)评分的差异.结果 治疗后,对照组RBMT评分较治疗前无显著性差异(t=1.233,P=0.223),观察组RBMT评分较治疗前提高(t=2.186,P=0.033),两组RBMT评分无显著性差异(t=1.133,P=0.262).治疗后,对照组WHOQOL-BREF评分仅在生理领域较治疗前显著提高(t=5.606,P<0.001),观察组WHOQOL-BREF评分在生理领域、心理领域、环境领域均较治疗前明显提高(t>2.879,P<0.01);观察组WHOQOL-BREF评分在生理领域、心理领域和环境领域均高于对照组(t>2.095,P<0.05),两组社会领域评分之间无显著性差异(t=0.508,P=0.614).结论 健侧低频rTMS可能对脑外伤患者记忆功能和生活质量的改善有促进作用.%Objective To observe the effect of low frequency repetitive transcranial magnetic stimulation at uninjured side on memory and quality of life in patients with traumatic brain injury. Methods From September, 2013 to June, 2015, 60 cases of memory impairment af-ter traumatic brain injury were randomly divided into control group (n=30) and observation group (n=30). The control group was given neu-rosurgical conventional treatment;the observation group was given low frequency repetitive transcranial magnetic stimulation in addition, for four weeks. The scores of Rivermead Behavior Memory Test (RBMT) and the World Health Organization Quality of Life-BREF (WHO-QOL-BREF) were observed before and after treatment in both groups. Results After treatment, there was no significant difference in the RBMT score in the control group (t=1.233, P=0.223);the RBMT score increased in the observation group (t=2.186, P=0.033);and there was no significant difference between two groups (t=1.133, P=0.262). After treatment, the WHOQOL-BREF score increased in physical health in the control group (t=5.606, P<0.001), while it increased in the physical, psychological health, and environment in the observation group (t>2.879, P<0.01), which were higher in the observation group than in the control group (t>2.095, P<0.05). There was no significant differ-ence in the social relationship between two groups (t=0.508, P=0.614). Conclusion Low frequency repetitive transcranial magnetic stimula-tion at uninjured side could improve the memory ability and quality of life for patients with traumatic brain injury.