摘要
目的 探讨重复经颅磁刺激(rTMS)联合康复训练对脑性瘫痪(简称脑瘫)患儿运动功能、认知功能及血清神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)水平的影响。方法 选取自2018年5月至2022年4月北部战区总医院及辽宁省残疾人服务中心收治的脑瘫患儿60例为研究对象,采用随机数表法分为康复训练组与联合训练组,每组30例。康复训练组患儿采用康复训练,联合训练组患儿在康复训练组基础上联合rTMS治疗。比较两组患儿运动功能、认知功能及血清NSE、MBP水平。结果 联合训练组患儿治疗后粗大运动功能量表、Peabody精细运动发育量表以及发育商子量表适应性、精细动作、大动作、个人社交得分均高于康复训练组,血清NSE、MBP浓度均低于康复训练组,差异有统计学意义(P<0.05)。治疗第2、4疗程,联合训练组Fugl-Meyer运动功能评定量表高于康复训练组,患侧拇指短展肌记录运动诱发电位潜伏期短于康复训练组,差异有统计学意义(P<0.05)。两组患儿均未出现不良反应。结论 rTMS联合康复训练可有效改善脑瘫患儿运动功能、认知功能,增加运动皮质兴奋性,降低血清NSE、MBP水平。
Objective To investigate the effect of repetitive transcranial magnetic stimulation(rTMS) combined with rehabilitation training on motor function,cognitive function and serum neuron-specific enolase(NSE)and myelin basic protein(MBP) in children with cerebral palsy.Methods A total of 60 children with cerebral palsy admitted to the General Hospital of the Northern Theater Command and Liaoning Provincial Service Center for the Disabled from May 2018 to April 2022 were selected as the research objects,and divided into rehabilitation training group and joint training group by random number table method, with 30 cases in each group.The children in the control group were given rehabilitation training, and the children in the observation group were treated with rTMS on the basis of the control group(the children not in the hospital were guided by tele-rehabilitation and assisted by local medical staff).The motor function,cognitive function,NSE and MBP of the two groups of patients were compared. Results After treatment,the gross motor function scale,Peabody fine motor development scale and developmental quotient subscale adaptation,fine motor,gross motor,personal social scores of children in the observation group were higher than those in the control group.The serum NSE and MBP concentrations in the control group were lower than those in the control group, and the difference was statistically significant(P <0.05).In the 2nd and 4th courses of treatment, the Fugl-Meyer motor function assessment scale in the observation group was higher than that in the control group,and the latency of motor evoked potential recorded by the abductor brevis muscle of the affected side was shorter than that in the control group, and the difference was statistically significant(P <0.05). There were no adverse reactions in both groups.Conclusion rTMS combined with rehabilitation training can effectively improve motor function and cognitive function in children with cerebral palsy, increase motor cortex excitability,and reduce serum NSE and MBP levels, which is worthy of clinical promotion.
作者
马瑛
赵明光
戴明
魏秀秀
王坤
MA Ying;ZHAO Ming-guang;DAI Ming;WEI Xiu-xiu;WANG Kun(Department of Neurosurgery,General Hospital of Northern Theater Command,Shenyang 110016,China)
出处
《创伤与急危重病医学》
2023年第1期35-38,42,共5页
Trauma and Critical Care Medicine
关键词
重复经颅磁刺激
脑性瘫痪
运动功能
认知功能
运动皮质兴奋性
Repetitive transcranial magnetic stimulation
Cerebral palsy
Motor function
Cognitive function
Motor cortex excitability
