rTMS联合高压氧治疗对重型颅脑损伤昏迷患者炎症因子、认知功能及脑血流的影响

doi:10.3969/j.issn.1671-7171.2021.07.008

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Abstract 【Objective】To explore the effect of repeated transcranial magnetic stimulation(rTMS) combined with hyperbaric oxygen treatment on inflammatory factors, cognitive function and cerebral blood flow in patients with severe head injury caused by coma. 【Methods】 A total of 120 comatose patients with severe craniocerebral injury treated in our hospital from October 2017 to February 2020 were randomly divided into observation group and control group, with 60 cases in each group. RTMS and rTMS combined with hyperbaric oxygen were used respectively. The changes of electroencephalogram(EEG), inflammatory factors, cerebral hemodynamics, Glasgow Coma Scale score(GCS), revised coma recovery scale score(CRS-R) and mini mental state examination scale score(MMSE) were compared between the two groups. 【Results】At 2 and 4 weeks after treatment, the GCS scores of the observation group were(10.49±3.26) and(13.87±1.41) respectively; The crs-r scores were(16.49±3.62) and(21.32±1.39) respectively. There was significant difference between the two groups(P<0.05). The total MMSE score of the observation group 4 weeks after treatment was(27.46±2.46), which was significantly higher than that of the control group(23.39±2.33)(P<0.05). At 2 and 4 weeks after treatment, the mean cerebral blood flow velocity(Vm), end diastolic blood flow velocity(Vd), middle cerebral artery peak systolic velocity(Vs), pulsatility index(PI), interleukin-6(IL-6) and tumor necrosis factor(TNF-α) and C-reactive protein(CRP) were better than those in the control group(P<0.05).【Conclusion】rTMS combined with hyperbaric oxygen is effective in the treatment of comatose patients with severe craniocerebral injury. It can reduce the level of inflammatory factors, improve cerebral blood flow and promote the recovery of cognitive function.

Key words： Craniocerebral Trauma/TH Hyperbaric Oxygenation/MT Electromagnetic Fields Physical Stimulation Cognition Cerebrovascular Circulation

Received: 22 April 2021

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R651.15

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2021.07.008 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2021/V38/I7/990

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