小脑顶核电刺激对脑梗死患者脑执行功能的影响

摘要

目的 探讨小脑顶核电刺激对脑梗死患者治疗前后脑执行功能的影响.方法 脑梗死患者270例,随机分成治疗组和对照组,各135例,均接受常规药物治疗,治疗组在此基础上加用小脑顶核电刺激,于治疗前和治疗后2周、3个月进行威斯康星卡片分类测验(WCST)、Strop色词测验、连线测验、词语流畅性测验.结果 治疗后2周,治疗组和对照组WCST分类次数、错误数、持续性错误数、非持续性错误数及Stroop色词测验的耗时数、正确数和连线测验A、语词流畅性均较治疗前有改善(P均＜0.05)；治疗后3个月,对照组在WCST分类次数、持续性错误数和Stroop色词测验的耗时数、正确数及连线测验、词语流畅性测验较治疗后2周下降(P均＜0.01),治疗组在WCST持续性错误数、非持续性错误数和Stroop色词测验的耗时数、连线测验A较2周末时有改善(P均＜0.05),其他测验无明显改善(P＞0.05).结论 电刺激小脑顶核能改善脑梗死患者的脑执行功能.%Objective To investigate the effect of fastigial nucleus electric stimulation on executive function of patients with cerebral infarction. Methods A total of 270 patients with cerebral infarction were divided into treatment group and control group, with 135 cases in each, and treated with routine treatment. The treatment group was given fastigial nucleus electric stimulation. All patients were evaluated with Wisconsin card sorting test( WCST) , Stroop color word test (SCWT) , trail making test A, verbal fluency test before treatments and 2 weeks,3 months after treatments. Results At 2 weeks after treatment, WCST grade, SCWT, trail making test A, verbal fluency test of treatment groups and control group were significantly improved compared with beginning of treatment ( all P < 0.05 ) . At 3 mouths after treatment, trail making test A, SCWT time-consuming value, WCST persisistent errors value and non-persisistent errors value of treatment group were improved compared with 2 weeks after treatment, which was statistical significance(all P <0.05). SCWT correct value and time-consuming value, WCST classification number, persisistent errors value, trail making test A, verbal fluency test of control group were decreased compared with 2 weeks after treatment (all P < 0.01). The rest of the cognitive tests scores were not statistical significance ( P > 0.05). Conclusion Executive function of patients with cerebral infarction can be increased by treatment of electric stimulaion on cerebellar fastigial nucleus.