rTMS治疗卒中后存在吞咽功能障碍的患者安全有效

2014-07-04 睿医摘编 睿医资讯

一项刊登在《中国脑血管病杂志》的研究表明,对卒中后存在吞咽功能障碍的患者,采用rTMS治疗可显著促进患者吞咽功能的恢复,并且安全、有效。 研究者采用计算机检索Pubmed、EMbase、MEDLINE、Cochrane图书馆、中文期刊全文数据库、中国生物医学文献数据库、万方数据库中关于rTMS治疗卒中后吞咽功能障碍的临床研究,截止日期为2013年12月。由2名研究者按纳入和排除标准选择文献、提取

一项刊登在《中国脑血管病杂志》的研究表明,对卒中后存在吞咽功能障碍的患者,采用rTMS治疗可显著促进患者吞咽功能的恢复,并且安全、有效。

研究者采用计算机检索Pubmed、EMbase、MEDLINE、Cochrane图书馆、中文期刊全文数据库、中国生物医学文献数据库、万方数据库中关于rTMS治疗卒中后吞咽功能障碍的临床研究,截止日期为2013年12月。由2名研究者按纳入和排除标准选择文献、提取资料、交叉核对,而后进行分析。

结果共纳入7篇研究(228例,其中rTMS 136例,对照92例),对4篇随机对照试验(RCT)进行Meta分析(rTMS组54例,对照组42例),另外3篇非RCT进行系统综述。

(1)Meta分析表明,rTMS治疗后吞咽功能评分的改善优于对照组(SMD =1.73,95%CI:0.45~3.01,P =0.008)。

(2)高频rTMS(>1 Hz)治疗后吞咽功能评分的改善与对照组比较,差异有统计学意义(SMD=1.60,95%CI:0.10~3.11,P=0.04);低频rTMS(1 Hz)与对照组相比,在一些吞咽功能评分的改善方面差异亦有统计学意义,提示低频治疗潜在的优势。

(3)rTMS治疗后,卒中患者Barthel指数的改善与对照组相比差异有统计学意义(MD=-21.60,95%CI:-36.21~-7.00,P=0.004)。

(4)在不良反应方面,7篇研究均未报道有头痛、耳鸣或癫痫等任何不良事件发作。

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  5. [GetPortalCommentsPageByObjectIdResponse(id=2045120, encodeId=5a7f20451203f, content=<a href='/topic/show?id=a0555302119' target=_blank style='color:#2F92EE;'>#患者安全#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53021, encryptionId=a0555302119, topicName=患者安全)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Sat Nov 22 04:31:00 CST 2014, time=2014-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1704858, encodeId=e4761e04858f7, content=<a href='/topic/show?id=15731e570a9' target=_blank style='color:#2F92EE;'>#TMS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17570, encryptionId=15731e570a9, topicName=TMS)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d5da30864141, createdName=360611850, createdTime=Sun Jul 27 06:31:00 CST 2014, time=2014-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1671179, encodeId=c7e216e11791d, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Sun Oct 26 16:31:00 CST 2014, time=2014-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2010934, encodeId=dcc6201093479, content=<a href='/topic/show?id=b6ca391652d' target=_blank style='color:#2F92EE;'>#吞咽功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39165, encryptionId=b6ca391652d, topicName=吞咽功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Sat Feb 14 05:31:00 CST 2015, time=2015-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=10493, encodeId=298910493cf, content=rTMS是深部脑磁刺激哦,现在用得很多了, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Tue Jul 15 23:59:00 CST 2014, time=2014-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=10479, encodeId=defa104e984, content=不知道rTMS是什么治疗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d2d2103784, createdName=chen111111, createdTime=Tue Jul 15 21:51:00 CST 2014, time=2014-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1421008, encodeId=a7d0142100882, content=<a href='/topic/show?id=09d33294eb8' target=_blank style='color:#2F92EE;'>#功能障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32947, encryptionId=09d33294eb8, topicName=功能障碍)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b3493649807, createdName=naiwu78, createdTime=Sun Jul 06 04:31:00 CST 2014, time=2014-07-06, status=1, ipAttribution=)]
    2014-07-15 lovetcm

    rTMS是深部脑磁刺激哦,现在用得很多了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2045120, encodeId=5a7f20451203f, content=<a href='/topic/show?id=a0555302119' target=_blank style='color:#2F92EE;'>#患者安全#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53021, encryptionId=a0555302119, topicName=患者安全)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Sat Nov 22 04:31:00 CST 2014, time=2014-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1704858, encodeId=e4761e04858f7, content=<a href='/topic/show?id=15731e570a9' target=_blank style='color:#2F92EE;'>#TMS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17570, encryptionId=15731e570a9, topicName=TMS)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d5da30864141, createdName=360611850, createdTime=Sun Jul 27 06:31:00 CST 2014, time=2014-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1671179, encodeId=c7e216e11791d, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Sun Oct 26 16:31:00 CST 2014, time=2014-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2010934, encodeId=dcc6201093479, content=<a href='/topic/show?id=b6ca391652d' target=_blank style='color:#2F92EE;'>#吞咽功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39165, encryptionId=b6ca391652d, topicName=吞咽功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Sat Feb 14 05:31:00 CST 2015, time=2015-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=10493, encodeId=298910493cf, content=rTMS是深部脑磁刺激哦,现在用得很多了, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Tue Jul 15 23:59:00 CST 2014, time=2014-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=10479, encodeId=defa104e984, content=不知道rTMS是什么治疗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d2d2103784, createdName=chen111111, createdTime=Tue Jul 15 21:51:00 CST 2014, time=2014-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1421008, encodeId=a7d0142100882, content=<a href='/topic/show?id=09d33294eb8' target=_blank style='color:#2F92EE;'>#功能障碍#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32947, encryptionId=09d33294eb8, topicName=功能障碍)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b3493649807, createdName=naiwu78, createdTime=Sun Jul 06 04:31:00 CST 2014, time=2014-07-06, status=1, ipAttribution=)]
    2014-07-15 chen111111

    不知道rTMS是什么治疗?

    0

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