标题：经颅磁刺激联合康复机器人训练对脑卒中患者偏侧忽略及视觉电生理的影响

      作者：陈春燕，袁华，惠楠，赵航琨，王淑雅    空军军医大学第一附属医院康复理疗科，陕西 西安 710032

      卷次： 2020年31卷17期

      【摘要】 目的 探讨经颅磁刺激(TMS)联合康复机器人训练对脑卒中患者偏侧忽略及视觉电生理的影响。方法 按照随机数表法将2018年1月至2019年6月空军军医大学第一附属医院收治的90例脑卒中左侧偏侧忽略患者分为联合组与对照组各45例。对照组患者使用康复机器人训练，联合组患者使用TMS联合康复机器人训练。比较两组患者治疗前、治疗 4周后的偏侧忽略症状[中国行为性忽略测试-香港版(CBIT-HK)]、视觉电生理[闪光视觉诱发电位(F-VEP)]、肢体功能[Fugl-Meyer运动功能评定量表(FMA)]及日常生活能力[改良Barthel指数(MBI)、日常生活能力评分量表(ADL)]。结果 治疗4周后，联合组患者CBIT-HK常规测试评分[(116.59±15.32)分]、行为测试评分[(68.63±5.57)分]及总评分[(185.57±20.33)分]均明显高于治疗前，且明显高于同期对照组的(103.59±14.37)分、(53.59±5.67)分、(160.23±22.54)分，差异均有显著统计学意义(P<0.01)；联合组患者的 F-VEP潜伏期为(30.59±1.63) ms，较治疗前明显缩短，且明显短于同期对照组的(33.47±1.52) ms，差异均有显著统计学意义(P<0.01)；联合组患者的波幅为(3.89±0.63) mV，较治疗前显著升高，且高于同期对照组的(3.43±0.55) mV，差异均有显著统计学意义(P<0.01)；联合组患者的ADL评分为(16.48±3.52)分，较治疗前明显下降，且明显低于同期对照组的(18.25±3.67)分，差异均有统计学意义(P<0.05或P<0.01)；联合组患者的FMA评分和MBI评分分别为(46.52±7.48)分、(63.83±7.25)分，较治疗前明显上升，且联合组明显高于同期对照组的(42.24±6.24)分、(56.95±7.14)分，差异均有显著统计学意义(P<0.01)。结论 TMS联合康复机器人训练能有效改善脑卒中患者偏侧忽略症状及视觉中枢电生理，改善患者肢体功能、提升日常生活能力。
      【关键词】 经颅磁刺激；康复机器人训练；脑卒中；偏侧忽略；视觉电生理
      【中图分类号】 R743.3 【文献标识码】 A 【文章编号】 1003—6350（2020）17—2187—04

Effects of transcranial magnetic stimulation combined with rehabilitation robot training on unilateral neglect andvisual electrophysiology in patients with stroke.
CHEN Chun-yan, YUAN Hua, HUI Nan, ZHAO Hang-kun, WANGShu-ya. Department of Rehabilitation Physiotherapy, the First Affiliated Hospital of Air Force Medical University, Xi’an710032, Shaanxi, CHINA
【Abstract】 Objective To explore the effects of transcranial magnetic stimulation (TMS) combined with reha-bilitation robot training on unilateral neglect and visual electrophysiology in patients with stroke. Methods Accordingto the random number table method, 90 patients with stroke and left lateral neglect admitted to the First Affiliated Hospi-tal of Air Force Medical University from January 2018 to June 2019 were divided into combined group and controlgroup, with 45 patients in each group. Patients in control group were given rehabilitation robot training, while patients incombined group were treated with TMS combined with rehabilitation robot training. The symptoms of unilateral neglect(Chinese Behavioral Inattention Test-Hong Kong Version [CBIT-HK]), visual electrophysiology (Flash Visual EvokedPotential [F-VEP]), limb function (Fugl-Meyer Motor Function Assessment Scale [FMA]), and daily living ability (Mod-ified Barthel Index [MBI], ability of daily living scale [ADL]) were compared between the two groups before treatment