功能性电刺激对脑卒中患者上肢体感及运动诱发电位的影响

Effects of functional electrical stimulation on somatosensory evoked potentials and motor evoked potentials of upper limbs of stroke patients

目的:观察功能性电刺激(FES)对脑卒中患者上肢体感诱发电位(SEP)及运动诱发电位(MEP)的影响。方法:符合入选标准的13例脑卒中患者分为FES组(9例)和FES安慰刺激组(4例)。患侧上肢腕背伸拇外展肌群接受FES治疗(30min)或安慰刺激(30min),FES治疗频率30Hz,脉宽200μs,强度为患者最大耐受量;治疗前后分别接受SEP及MEP检测,记录SEP检测中N9及N20潜伏期和波幅,MEP检测中正中神经的肘部刺激点,臂丛区刺激点,C7刺激点及皮质刺激点潜伏期和波幅;比较同一测试时间点MEP重复检测的信度,并对组内同侧治疗前后,组间治疗前后SEP、MEP变化率进行比较。结果:2组患者MEP值各部位5次测量值的相关系数值均在0.8317—1.0000之间;2组患者患侧皮质MEP均未引出;FES组治疗后患侧SEP及MEP潜伏期均有缩短,波幅明显增高(P<0.05);FES组健侧和安慰刺激组双侧刺激后SEP及MEP变化不明显;刺激前后变化率比较差异有显著性意义(P<0.05)。结论:脑卒中患者患侧上肢FES后SEP及MEP潜伏期有缩短,波幅有增高。

Objective： To observe the effects of functional electrical stimulation（FES） on somatosensory evoked potential （SEP） and motor evoked potential （MEP） of upper limbs of stroke patients. Method： Thirteen cases with first stroke were divided into two groups according to the order of hospital admission; one group （9 cases） received FES treatment on the affected upper limb, the other group（4 cases） received FES placebo treatment. SEP and MEP were recorded before and after 30min treatment. The latencies and amplitudes of N9,N20 of SEP and elbow point, Erb＇s point, C7 point, cortex point of MEP were measured for analysis. Result： In the two groups ICCs （interclass correlation coefficients） of MEP were between 0.8317--1.0000. The latencies of SEP and MEP were shortened and the amplitudes were significantly higher on the affected side in FES treatment group after 30min stimulation （P〈 0.05）. There was no significant difference of the change of SEP and MEP after both side stimulation on the unaffected side of FES treatment group and in FES placebo group. Conclusion： After FES on the affected side of upper limbs of stroke patients, the lateneies of SEP and MEP were shortened and the amplitudes were heightened.