首页|高压氧联合高频rTMS对重型颅脑损伤后意识障碍患者促醒作用、神经电生理和脑损伤标志物的影响

高压氧联合高频rTMS对重型颅脑损伤后意识障碍患者促醒作用、神经电生理和脑损伤标志物的影响

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目的:探讨高压氧联合高频重复经颅磁刺激(rTMS)对重型颅脑损伤后意识障碍(DOC)患者促醒作用、神经电生理和脑损伤标志物的影响。方法:选取2021年6月～2023年6月期间安徽中医药大学附属六安医院收治的的80例重型颅脑损伤后DOC患者。根据随机数字表法分为对照组(n=40，高压氧治疗)和观察组(n=40，高压氧联合高频rTMS治疗)。对比两组疗效、促醒作用、神经电生理和脑损伤标志物水平变化情况。结果:观察组的临床总有效率高于对照组(P＜0。05)。两组治疗4周后修订的昏迷恢复量表(CRS-R)、格拉斯哥昏迷量表(GCS)评分升高，观察组高于对照组(P＜0。05)。两组治疗4周后脑干听觉诱发电位(BAFP)、四肢体感诱发电位(SEP)、脑电图(EEG)分级有所改善，观察组改善效果优于对照组(P＜0。05)。两组治疗4周后髓鞘碱蛋白(MBP)、神经元特异性烯醇化酶(NSE)、S100β蛋白下降，观察组低于对照组(P＜0。05)。结论:高压氧联合高频rTMS治疗可有效促醒重型颅脑损伤后DOC患者，还可改善神经电生理活动，减轻脑损伤程度。
Effects of Hyperbaric Oxygen Combined with High-Frequency rTMS on Wake-Promoting Effect,Neuroelectrophysiology and Brain Injury Markers in Patients with Disturbance of Consciousness after Severe Craniocerebral Injury
Objective:To investigate the effects of hyperbaric oxygen combined with high-frequency repetitive transcranial magnet-ic stimulation(rTMS)on wake-promoting effect,neuroelectrophysiology and brain injury markers in patients with disturbance of con-sciousness(DOC)after severe craniocerebral injury.Methods:80 patients with DOC after severe craniocerebral injury who were admit-ted to Lu'an Hospital Affiliated to Anhui University of Traditional Chinese Medicine from June 2021 to June 2023 were selected.Patients were divided into control group(n=40,hyperbaric oxygen therapy)and observation group(n=40,hyperbaric oxygen combine with high-frequency rTMS therapy)according to the random number table method.Control group received hyperbaric oxygen therapy,and observation group received hyperbaric oxygen combine with high-frequency rTMS therapy.The efficacy,wake-promoting effect,neuro-electrophysiology and brain injury markers were compared between two groups.Results:The total clinical effective rate in observation group was higher than that in control group(P＜0.05).The scores of revised coma recovery scale(CRS-R)and Glasgow coma scale(GCS)in two groups increased 4 weeks after treatment,and observation group was higher than that of control group(P＜0.05).The brainstem au-ditory evoked potential(BAFP),four limb sensory evoked potential(SEP)and electroencephalogram(EEG)grading were improved in two groups 4 weeks after treatment,and the improvement effect in observation group was better than that in control group(P＜0.05).Myelin basic protein(MBP),neuron-specific enolase(NSE)and S100β protein decreased in two groups 4 weeks after treatment,and obser-vation group was lower than that of control group(P＜0.05).Conclusion:Hyperbaric oxygen combined with high-frequency rTMS therapy can effectively wake up patients with DOC after severe craniocerebral injury,improve neuroelectrophysiological activities,and reduce the degree of brain injury.

Hyperbaric oxygenHigh-frequency repetitive transcranial magnetic stimulationSevere craniocerebral injuryDistur-bance of consciousnessWake-promoting effectNeuroelectrophysiologyBrain injury markers

孙平平、范家权、沈丽、赵丽、徐萍

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安徽中医药大学附属六安医院神经外一科 安徽六安 237000

高压氧 高频重复经颅磁刺激 重型颅脑损伤 意识障碍 促醒作用 神经电生理 脑损伤标志物

安徽省红十字会中医药传承创新发展研究计划

2021ZYZD04

2024

10.13241/j.cnki.pmb.2024.07.024

现代生物医学进展
黑龙江省森工总医院 哈尔滨医科大学附属第四医院

现代生物医学进展

CSTPCD
影响因子：0.755
ISSN：1673-6273
年,卷(期)：2024.24(7)
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