高压氧联合重复经颅磁刺激治疗脑梗死患者认知功能的疗效观察

关键词：高压氧  重复经颅磁刺激  脑梗死  认知障碍

Keywords:hyperbaric oxygen  repetitive transcranial magnetic stimulation  cerebral infarction  cognitive disorder

摘要：

      摘要 目的：观察高压氧（HBO）联合重复经颅磁刺激（rTMS）治疗对脑梗死后患者认知功能的改善情况。 方法：采用随机数字表法随机将90例脑梗死患者分为治疗组和对照组，每组45例。两组患者均给予常规治疗（常规药物治疗及认知功能训练），对照组患者在常规治疗基础上给予rTMS治疗，治疗组患者在常规治疗基础上给予HBO和rTMS联合治疗。两组患者均于治疗前和治疗4周后分别采用蒙特利尔认知评估量表（MoCA）进行认知功能评估，同时检测事件相关电位（P300）潜伏期及波幅改善情况。 结果：治疗前两组患者的MoCA评分及P300潜伏期及波幅组间差异均无显著性意义（P＞0.05）；治疗后，两组患者MoCA评分较组内治疗前均明显改善（P＜0.05），除语言项目外，治疗组的MoCA评分显著高于对照组，差异具有显著性意义（P＜0.05）。两组治疗后P300潜伏期及波幅均显著优于对照组水平，差异均具有显著性意义（P＜0.05）。 结论：HBO联合rTMS治疗比单独rTMS治疗脑梗死患者的认知障碍效果更显著，该疗法值得临床推广。

Abstract:

      Abstract Objective: To explore the effects of hyperbaric oxygen (HBO) combine with repetitive transcranial magnetic stimulation (rTMS) treatment on the cognitive ability in patients with cognitive impairment after ischemic stroke. Method: Ninety patients with cerebral infarction were randomly divided into treatment group (45 cases) and control group (45 cases). Both groups were given conventional treatment (drug therapy and cognitive function training). Control group was treated by TMS on the basis of conventional therapy, while treatment group was treated by HBO combined with TMS on the basis of conventional therapy.All treatment lasted for 4 weeks. Pretreatment and post-treatment Montreal Cognitive Assessment (MoCA) scores and auditory P300 were compared between the two groups. Result: There was no significant difference in MOCA score, P300 latency and wave amplitude between the two groups (P＞0.05). After treatment, the MoCA scores of the two groups were significantly improved compared with those before treatment(P＜0.05). Except language items, MoCA score of treatment group was significantly higher than that of the control group with statistically significant difference(P＜0.05). After treatment,the P300 latency and amplitude in the treatment group were significantly higher than those in the control group(P＜0.05). Conclusion: The HBO combined with rTMS therapy has better curative effect than the rTMS alone when treat patients with cerebral infarction. This therapy is worthy of clinical application.