脊髓损伤患者肛门外括约肌电生理分析

Electromyographyanalysisof external anal sphincterin spinal cord injury patients

目的观察和分析脊髓损伤患者和神经外科非脊髓损伤患者肛门外括约肌的肌电图（EAS—EMG）特点，探讨EAS—EMG对于不同脊髓损伤程度的诊断价值。方法利用肛门外括约肌肌电图，检测了99例脊髓损伤患者以及与其性别年龄一致的10例神经外科非脊髓损伤患者。结果脊髓损伤组和对照组自发电位（SA）出现率分别为79．8％和0％，组间差异具有统计学意义（P〈0．01）。脊髓损伤组运动单位动作电位（MUAP）平均时限和平均项数显著高于对照组（P〈0．01）。不同脊髓损伤级别患者组间MUAP发放情况和SA出现率差异具有统计学意义（P〈0．01）。不同脊髓损伤级别患者组间MUAP时限（P〈0．01）和平均项数差异具有统计学意义（P〈0．05）。脊髓损伤组运动单位时限随病程不同数值有波动性变化，1—6个月病程患者MUAP时限为（14．66±2．19）ms，13—24个月病程患者MUAP时限增至（17．25±1．50）ms，24个月之后时限稳定在15ms左右。结论全部脊髓损伤组研究对象的EAS—EMG均有不同程度的异常，脊髓损伤级别及病程对EAS—EMG指标变化有决定性作用。

Objective To explore and analyze the electromyographyof external anal sphincter electromyography （EAS -EMG） of 99spinal cord injury （SCI） cases, and to discuss the diagnostic value of EAS - EMG for judging the serious degree of SCI. Methods The EAS - EMG of 99cases of SCI from the outpatient department and those of the same gender and age that didn ~t suffer from SCI as controlwere measured. Results The spontaneous potentialsincidenceof the SCI group and the control were 79. 8% and 0% respectively. The difference between groups was significant （ P 〈 0. 01 ）. The average durations and phases of motor unit actionpotential （MUAP） of the SCI group weresignificantly higher than those of control group （P 〈0. 01 ）. And what was more, among different grades of SCI, the differences of MUAP and SP were significant （P 〈 0. 01 ） , the durationsof action potentials and average phases were significantly different （P 〈 0. 01 and P 〈 0.05respectively）. We also observed that the durationsof AP were changed in different time periods. The mean durationsof AP was（ 14. 66 -s 2. 19 ） ms incasesduring 1 ~ 6 months and then increased to （ 17.25 ± 1.50） ms during 13 - 24 months, and was 15 ms steadily after 24 months . Conclusions EAS -EMGmay show abnormality of varying degrees in SCI patients. The degreesand duration of SCI play a decisive role in the changes of EAS - EMG.