經顱磁刺激結合神經節苷脂穴位注射對腦性癱瘓智力發育的影響

吳桂華　黃裕斌　邵銀進

【摘要】 目的：觀察經顱磁刺激治療結合神經節苷脂穴位注射對腦性癱瘓智力發育的影響。方法：選取2015年6月-2016年10月本科室收治的腦性癱瘓患兒60例，采用隨機數字表法將其分為觀察組和對照組，每組30例。對照組給予常規康復治療，觀察組給予經顱磁刺激結合神經節苷脂穴位注射，并配合常規康復治療。采用Gesell發育診斷量表社會適應性能力發育商DQ評定兩組患兒治療3個月后智力發育情況，采用腦彩超檢測大腦血流動力學，并評價其治療有效率。結果：治療后，兩組社會適應性能力發育商DQ均優于治療前，差異均有統計學意義（P<0.05）；且觀察組優于對照組（P<0.05）。隨著治療次數的增加，兩組大腦中動脈、后動脈組收縮期峰值速度、舒張末期速度、平均血流速度均升高，血管阻力指數均降低，差異均有統計學意義（P<0.05）；且觀察組均明顯優于對照組，差異均有統計學意義（P<0.05）。觀察組治療總有效率為86.7%，高于對照組的73.3%，差異有統計學意義（P<0.05）。結論：經顱磁刺激結合神經節苷脂穴位注射能夠有效改善腦性癱瘓患兒智力發育，提高患兒整體健康水平。

【關鍵詞】 經顱磁刺激； 神經節苷脂； 腦性癱瘓； 智力發育

The Effect of Transcranial Magnetic Stimulation Combined with Ganglioside Injection on Mental Development of Cerebral Palsy/WU Gui-hua，HUANG Yu-bin，SHAO Yin-jin.//Medical Innovation of China，2017，14（27）：001-004

【Abstract】 Objective：To observe the effect of transcranial magnetic stimulation combined with ganglioside injection on cerebral palsy mental development.Method：A total of 60 children with cerebral palsy from June 2015 to October 2016 were divided into the observation group and the control group by random number table method，30 cases in each group.The control group was given conventional rehabilitation therapy，the observation group was given transcranial magnetic stimulation combined with ganglioside injection，and with conventional rehabilitation.The mental development of two groups were assessed by the developmental fitness of the Gesell Developmental Diagnostic Scale，and the hemodynamics of the brain of two groups were measured and the therapeutic efficiency of two groups were evaluated.Result：After treatment，the DQ of the two groups were better than those before treatment （P<0.05）；and the observation group were better than those of the control group（P<0.05）.The peak velocity，end diastolic velocity，mean blood flow velocity and vascular resistance index of two groups decreased with the increase of the number of treatment，the differences were statistically significant（P<0.05）；and the observation group were better than those of the control group，the difference was statistically significant（P<0.05）.The total effective rate of the observation group was 86.7%，higher than 73.3% of the control group，the difference was statistically significant（P<0.05）.Conclusion：Transcranial magnetic stimulation combined with ganglioside injection can improve the mental development of children with cerebral palsy and improve the overall health of children.

【Key words】 Transcranial magnetic stimulation； Ganglioside； Cerebral palsy； Mental developmentendprint

First-authors address：Ganzhou Peoples Hospital，Ganzhou 341000，China

doi：10.3969/j.issn.1674-4985.2017.27.001

腦性癱瘓是一組持續存在的中樞性運動和姿勢發育障礙、活動受限癥候群，常伴有感覺、知覺、認知、交流、行為障礙以及癲癇、繼發性肌肉骨骼問題[1]。世界衛生組織流行病學調查研究發現，全球的腦癱患病率為1.5‰～4‰，我國的腦癱發病率略高于世界平均水平，為1.8‰～4‰[2]。由于近年來醫療技術水平的不斷進步，早產兒、極低體重兒等腦癱高危兒的死亡率大幅度降低，因此腦癱患兒的患病率在逐年提高[3]。其中伴有智力障礙癥狀的患兒約占52%，嚴重影響了患兒的整體健康，造成機體其他各項能力的缺陷。提高腦癱患兒的智力水平，對提高腦癱患兒的整體治療效果十分關鍵。目前，大多治療方案多針對患兒的運動功能障礙以及矯正患兒的異常姿勢，對于改善智力障礙的方案較少[4]。……