经皮电刺激促进腓总神经损伤后神经再生的临床研究

Transcutaneous electrical nerve stimulation for nerve regeneration after peroneal nerve injury: a randomized controlled clinical study

目的证实经皮电刺激对周围神经(本文选择腓总神经)完全损伤后神经再生的促进作用,并探讨最佳的电刺激的参数、波形优化组合等治疗方案。方法对30例腓总神经完全损伤患者,随机分为电刺激组和对照组,每组15例,在行神经缝合术后,各组同时服用神经营养药物治疗,电刺激组在术后4周石膏拆除后加用电刺激治疗。经过方波和变频波的交替使用,之后均使用变幅脉冲波+肌肉训练波,并适度增加肌肉训练波的治疗时间。术后随访内容:术后6个月进行足趾伸屈力,神经电生理检测。结果电刺激组的临床肌力与肌电图结果均优于对照组,两组差异有统计学意义(P<0.05)。电刺激组的肌力恢复时间与肌电图恢复时间也明显短于对照组,两组差异有统计学意义(P<0.05)。结论经皮电刺激治疗具有促进受损周围神经再生和传导功能恢复的作用,并且能减少受损骨骼肌的萎缩,尤其对电刺激仪的工作参数、电流波形进行优化组合后,可获得更好的疗效。

Objective To assess the clinical effects of transculaneous electrical nerve stimulation（TENS） on nerve regeneration after complete peroneal nerve injury.To investigate the parameters and waveforms of the electrical stimulation.Methods A total of 30 cases of peroneal nerve complete injury were included in the study.They were randomly distributed into two groups after nerve repair surgery.Electrical stimulation group patients were given with TENS and medication.Control group patients were treated with medication only.Electrical stimulation was applied 4 weeks after plaster removal.After alternation of square wave and pulsat wave,muscle strength of wrist extensors and finger extensors,compound muscle action potentials were evaluated.Results Shorter recovery time determined by muscle strength and electromyogram activity was observed in the electrical stimulation group（P〈0.05）.Conclusion Transcutaneous electrical stimulation has obvious effect on promoting nerve regeneration after peroneal nerve injury.A better therapeutic benefit can be achieved by optimizing the regimen of parameters and waveforms.