摘要：

目的 探讨小脑顶核电刺激治疗脑卒中后睡眠障碍的有效性和安全性。 方法 共69 例脑卒中后睡眠障碍患者随机接受常规治疗（对照组，23 例）、常规治疗联合断路的小脑顶核电刺激（假治疗组，23 例）及常规治疗联合小脑顶核电刺激（治疗组，23 例），分别于治疗前和治疗4 周时采用匹兹堡睡眠质量指数（PSQI）评价睡眠质量，并记录小脑顶核电刺激不良反应。 结果 3 组患者治疗前后PSQI 评分差异有统计学意义（P = 0.020），其中治疗4 周时治疗组PSQI 评分低于对照组和假治疗组（P = 0.000，0.000）；与治疗前相比，3 组患者治疗4 周时PSQI 评分均降低（P = 0.000）。 结论 小脑顶核电刺激能够有效改善脑卒中后睡眠障碍患者的睡眠质量且安全性良好，可以作为辅助康复治疗方法之一。

关键词: 卒中, 睡眠障碍, 小脑, 深部脑刺激法

Abstract:

Objective To discuss the efficacy and safety of fastigial nucleus stimulation (FNS) in the treatment of post-stroke sleep disorders (PSSD). Methods A total of 69 cases with PSSD were randomly divided into 3 groups: control group (N = 23), sham group (N = 23) and treatment group (N = 23). Control group received routine treatment, sham group received routine treatment plus sham FNS treatment, and treatment group received routine treatment plus FNS treatment. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of patients in 3 groups before and after 4-week treatment. Adverse reactions during the FNS treatment were also observed. Results There was statistical significance in PSQI scores among 3 groups before and after 4-week treatment (P = 0.020). PSQI score after 4-week treatment in treatment group was significantly lower than control group and sham group (P = 0.000, 0.000). Compared to before treatment, PSQI scores were significantly decreased in 3 groups after 4-week treatment (P = 0.000). Conclusions FNS safely and effectively improves the sleep quality of patients with PSSD, thus it can be used as one of the auxiliary treatments for curing PSSD.

Key words: Stroke, Sleep disorders, Cerebellum, Deep brain stimulation