重复经颅磁刺激联合康复训练对老年重症脑卒中患者肢体功能障碍恢复效果的影响观察

摘要

目的 探讨重复经颅磁刺激(rTMS)联合康复训练在老年重症脑卒中患者肢体功能障碍治疗中的应用效果.方法 选取2016年5月至2017年6月于本院就诊的98例脑卒中患者作为受试对象,按随机数表法分为rTMS+康复治疗组(研究组,n=49)和康复治疗组(对照组,n=49).治疗前、治疗14 d后评估两组患者运动功能[Fugl-Meyer运动功能评分(FMA)]和生活质量[诺丁汉健康调查表(NHP)].结果 治疗14 d后,两组FMA评分均较治疗前明显增加(P＜0.01),其中研究组FMA评分明显高于对照组(P＜ 0.01).治疗14 d后,两组NHP评分均较治疗前降低(P＜0.01),研究组降幅显著大于对照组(P＜0.01).结论 rTMS刺激健侧大脑半球M1区可改善卒中后肢体功能障碍,结合康复训练效果更好.%Objective To explore the effect of repetitive transcranial magnetic stimulation (rTMS)combined with rehabilitation training on limb dysfunction in elderly patients with severe stroke.Methods From May 2016 to June 2017,98 stroke patients treated in our hospital were taken as the research objects,and were randomly divided into rTMS plus rehabilitation training group (study group,n=49) and rehabilitation training group (control group,n=49).The scores of motor function [Fugl-Meyer assessment (FMA)] and life quality [Nottingham health profile (NHP)] in the two groups were assessed before and 14 d after treatment.Results 14 d after treatment,the FMA scores in the two groups significantly increased (P＜0.01),and the increase range in the study group was significantly larger than that in the control group (P＜0.01);the NHP scores in the two groups significantly decreased (P＜0.01),and the decrease range in the study group was significantly larger than that in the control group (P＜0.01).Conclusion rTMS can not only stimulate the M1 region of unaffected hemisphere,improve the limb dysfunction of patients with stroke,and the effect of rTMS combined with rehabilitation training is better.