Abstract: Objective To analyze the effect of repetitive transcranial magnetic stimulation (rTMS) combined with functional electrical stimulation (FES) in children with global developmental delay (GDD). Methods A total of 54 children with GDD, who were treated in Nanning Maternal and Child Health Hospital from January 2020 to April 2022, were included in this study, and were divided into control group and experimental group. The control group received rehabilitation training and rTMS, while the experimental group received FES additionally. Development quotient (DQ) was assessed by Gesell Development Scale before and after intervention and statistical analysis was performed. Results There were no statistically significant difference in the general characteristics and DQ of the five dimensions by Gesell before intervention between the two groups(P＞0.05). After 6 months of intervention, DQ of the five dimensions by Gesell of children in the two groups were significantly improved compared with those before intervention (P＜0.05). DQ of speech ability dimension in the experimental group (51.11±18.84)was significantly higher than that in the control group (40.93±15.47) after intervention (t=2.171, P＜0.05). Significant effective rate (55.6% vs.14.8%) and effective rate (29.6% vs. 22.2%) of speech ability dimension in experimental group were significantly higher than those in control group after intervention (Z=3.963, P＜0.05). Conclusion The mode of rTMS combined with FES can significantly improve the language development of children with GDD, and reduce the long-term treatment cost of family and society.

Key words: global development delay, repetitive transcranial magnetic stimulation, functional electrical stimulation, cooperation mode

摘要： 目的 研究重复经颅磁刺激(rTMS)联合功能电刺激(FES)对全面发育迟缓(GDD)患儿的疗效,为改善GDD患儿语言康复提供临床参考依据。方法 以2020年1月—2022年4月在南宁市妇幼保健院所就诊的54例GDD患儿为研究对象,分为对照组和实验组,对照组予康复训练+rTMS干预,实验组在对照组的基础上增加FES干预,在干预前后进行Gesell发育诊断量表评定发育商数(DQ)并进行统计学分析。结果 干预前两组患儿一般资料与Gesell评定5个维度DQ值差异无统计学意义(P＞0.05),经6个月的干预后两组患儿Gesell评定5个维度DQ值较干预前均提高且差异具有统计学意义(P＜0.05),干预后实验组言语能维度DQ为(51.11±18.84),高于对照组的(40.93±15.47),且差异具有统计学意义(t=2.171,P=0.034),干预后实验组言语能疗效显效率(55.6%)与有效率(29.6%)均高于对照组(显效率14.8%,有效率22.2%)且差异具有统计学意义(Z=3.963,P＜0.001)。结论 rTMS联合FES的“中枢-外周”协同模式可明显改善GDD患儿的语言发展,降低家庭与社会的长期治疗成本。

关键词: 全面发育迟缓, 重复经颅磁刺激, 功能电刺激, 协同模式