| 李花,许济,田苗,等.立体定向指导下经颅磁刺激对重型颅脑损伤的治疗价值[J].安徽医药,2021,25(5):979-982. |
| 立体定向指导下经颅磁刺激对重型颅脑损伤的治疗价值 |
| The value of transcranial magnetic stimulation under the guidance of stereotactic in treatment of severe cranial-cerebral injury |
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| DOI：10.3969/j.issn.1009-6469.2021.05.033 |
| 中文关键词: 颅脑损伤 立体定位技术 经颅磁刺激 癫痫 格拉斯哥昏迷评分量表 |
| 英文关键词: Craniocerebral trauma Stereotaxic techniques stereotactic Transcranial magnetic stimulation Epilepsy GCS score |
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| 中文摘要: |
| 目的探讨立体定向指导下的经颅磁刺激方案对重型颅脑损伤昏迷病人的治疗价值。方法选取 2017年 9月至 2019年 9月西安交通大学医学院附属三二〇一医院收治的重型颅脑损伤病人 90例。采用随机数字表法分为常规治疗组、普通经颅磁刺激( TMS)组与立体定向指导下的经颅磁刺激( sTMS)组，每组各 30例。观察三组治疗 7d后的有效率，格拉斯哥昏迷评分量表( GCS)评分变化、神经科重症监护室( NICU)住院时间、平均住院时间、癫痫、脑疝发生率及肺部感染等并发症的发生率。结果 sTMS组治疗有效率( 96.7%)明显高于 TMS组(80.0%)与常规治疗组( 50.0%)(P<0.05)； sTMS组病人 NICU住院时(9.23±2.69)d与平均住院时间( 53.70±10.00)d较常规治疗组( 27.23±6.63)、(94.40±7.78)d均明显减少( P<0.05)； sTMS组癫痫生率明显低于 TMS组的与常规治疗组( 3.3%比 40.0%、40.0%，P <0.05)，而脑疝、肺感染等发生率三组间差异无统计学意义(P >0.05)。结论立体定向指导下的经颅磁刺激治疗方案有助于促进重型颅脑损伤病人的觉醒，减少了住院时间，并降低了发间癫痫的发生率，优于普通经颅磁刺激治疗。 |
| 英文摘要: |
| Objective To explore whether stereotactic guided transcranial magnetic stimulation (TMS) has an advantage on comatose patients with severe cranial-cerebral injury.Methods 90 patients with severe cranial-cerebral injury were admitted to 3201 Hospital Affiliated to Xi′an Jiaotong University from September 2017 to September 2019. Using random number table method, they were divided into conventional treatment group, ordinary transcranial magnetic stimulation (TMS) group and stereotactically guided transcranial magnetic stimulation (sTMS) group, with 30 cases in each group. Observe the effective rate of the three groups after 7 days of treatment, the changes in the Glasgow Coma Score Scale (GCS) score, the length of stay in the Neurological Intensive Care Unit (NICU), the average length of stay, the incidence of epilepsy, brain herniation, and complications such as lung infections The rate of occurrence.Re? sults the effective rate (96.7%) in the STMs group was significantly higher than that in the TMS group (80.0%) and the control group(50.0%) (P< 0.05); the hospitalization time[(9.23±2.69)d vs. (27.23±6.63)d] and the average hospitalization time[(53.70±10.00)d vs. (94.40±7.78)d] of NICU in the STMs group were significantly shorter than those in the control group (P < 0.05); the incidence of epilepsy in the STMs group was significantly lower than that in the TMS group and the control group (3.3% vs. 40.0%,40.0%,P <0.05), but there was no significant difference in the incidence of brain hernia and lung infection among the three groups(P > 0.05).Conclusion Stereotactic guided transcranial magnetic stimulation is superior to normal transcranial magnetic stimulation on promoting the awakening of patients with severe cranial-cerebral injury, reducing the length of stay, as well as the incidence of complications such as epilepsy, which is better than ordinary transcranial magnetic stimulation. |
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