目的 分析重复经颅磁刺激(repetitive Transcranial Magnetic Stimulation，rTMS)联合神经肌肉电刺激(Neuromus-cular Electrical Stimulation，NMES)治疗对急性脑梗死(Acute Cerebral Infarction，ACI)患者吞咽功能、生活质量的影响。方法 选取2020年12月—2023年11月期间我院收治的126例ACI患者，入组者均行常规治疗，根据"电刺激"疗法的不同分为两组。对照组63例行NMES治疗，研究组63例在对照组基础上行联合rTMS治疗。对比两组神经功能、吞咽功能、脑血流及生活质量。结果 研究组治疗1周后、2周后及4周后美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale，NIHSS)评分低于对照组，吞咽障碍特异性生存质量量表(Swallowing Quality of Life，SWAL-QOL)评分高于对照组(P＜0。05)。两组治疗后中文版吞咽功能评估量表(Gugging Swallowing Screen，GUSS)、功能性经口摄食量表(Functional Oral Intake Scale，FOIS)评分较同组治疗前均提高，且研究组提高更明显(P＜0。05)。两组治疗后标准吞咽功能评定量表(Standardized Swallowing As-sessment，SSA)评分较同组治疗前均降低，且研究组降低更明显(P＜0。05)。两组治疗后左右椎动脉、基底动脉平均血液流速(Average Blood Flow Rate，Vm)水平较同组治疗前均升高，且研究组升高更明显(P＜0。05)。两组治疗后左右椎动脉、基底动脉搏动指数(Pulse index，PI)水平较同组治疗前均降低，且研究组降低更明显(P＜0。05)。结论 脑梗死患者应用rTMS联合NMES治疗，可改善患者神经功能，促进吞咽功能改善，并改善脑血流有利于提高患者生活质量。
The effect of repeated transcranial magnetic stimulation combined with neuromuscular electrical stimulation in the treatment of cerebral infarction
Objective To analyze the effects of repeated transcranial magnetic stimulation(rTMS)combined with neuromuscular electrical stimulation(NMES)on swallowing function and quality of life in patients with cerebral infarction.Methods 126 patients with acute cerebral infarction(ACI)admitted to our hospital from December 2020 to November 2023 were enrolled.All patients received routine treatment and were divided into two groups according to the level of electrical stimulation.The control group received NMES treatment in 63 cases,and the study group received rTMS treatment on the basis of the control group.Nerve function,swallowing function,cerebral blood flow and quality of life were compared between the two groups.Results The National Institute of Health Stroke Scale(NIHSS)score of the study group was lower than that of the control group after 1 week,2 weeks and 4 weeks of treatment.The Swallowing Quality of life(SWAL-QOL)score was higher than that of the control group(P＜0.05).After treatment,the scores of the Chinese version of the GuUSS Swallowing Screen(GUSS)and the Functional Oral Intake Scale(FOIS)were improved compared with those before treatment.The increase was more significant in the study group(P＜0.05).Standardized Swallowing Assessment(SSA)scores in both groups were lower after treatment than before treatment,and the reduction was more obvious in the study group(P＜0.05).The Average Blood Flow Rate(Vm)of the left and right vertebral artery and basilar artery in the two groups after treatment was higher than that before treatment,and the increase was more significant in the study group(P＜0.05).After treatment,the Pulse index(PI)of left and right vertebral artery and basilar artery in both groups was lower than that before treatment,and the decrease was more significant in the study group(P＜0.05).Conclusion rTMS combined with NMES can improve nerve function,improve swallowing function,and improve cerebral blood flow in patients with cerebral infarction,which is conducive to improving patients'quality of life.
Repetitive transcranial magnetic stimulationCerebral infarctionNeuromuscular electrical stimulationSwallowing functionQuality of life
NETL
NSTL
万方数据
