应用肌电图仪对损伤周围神经行经皮电刺激治疗的方法与疗效评估

THE EFFECT AND METHOD ASSESSMENT OF TRANSCUTANEOUS ELECTRICAL STIMULATION TREATMENT ON INJURED PERIPHERAL NERVE UTILIZING EMG INSTRUMENT

目的：评估应用肌电图仪进行经皮电刺激治疗对损伤周围神经功能恢复的促进作用,探讨电刺激治疗的最佳方法.方法：60例经神经电生理检查确诊腓总神经不全损伤的患者,男女不限,年龄20～35岁,采用随机数字表法将患者分为3组（n=20）,非电刺激治疗组（NS组）、电刺激治疗1组（S1组）、电刺激治疗2组（S2组）.NS组不给予电刺激治疗;S1组电刺激治疗每日10分钟,连续10天;S2组电刺激治疗每日10分钟,连续20天.3个月后复查腓总神经传导速度（NCV）与趾短伸肌复合肌肉动作电位（CMAP）波幅,比较3组患者治疗前后腓总神经电生理数据改善程度.结果：（1）NS组、S1组和S2组腓总神经NCV分别增加3.7±2.4 m/s、7.5±4.3 m/s和7.5±3.1 m/s,与NS组比较,S1组和S2组的腓总神经NCV均增加（P＜0.05）;与S1组比较,S2组的腓总神经NCV无增加（P＞0.05）.（2）NS组、S1组和S2组趾短伸肌CMAP波幅分别增加2.7±1.8mv、4.1±1.9mv和5.3±2.0mv,与NS组比较,S1组和S2组的趾短伸肌CMAP波幅均增加（P＜0.05）;与S1组比较,S2组的腓总神经CMAP波幅增加（P＜0.05）.结论：（1）经皮电刺激治疗对不全损伤周围神经功能的恢复有明显的促进作用,表现为NCV增快、CMAP波幅增加.（2）延长经皮电刺激治疗疗程有利于神经功能恢复.

] Objective： To evaluate the improvement of injured peripheral nerve function after transcutaneous electrical stimulation treatment with EMG instrument and investigate the best way to apply the electrical stimulation treatment. Methods： 60 patients diagnosed by neurophysiological tests as peroneal nerve injury, male or female don＇t restrict, age was 20 to 35 years, were randomly divided into three groups （ n=20 ） ：non-electrical stimulation group （ group NS ） , electrical stimulation group 1 （ group S1 ） , electrical stimulation group 2 （ group S2 ） . Group NS received no electrical stimulation treatment. Group S1 received electrical stimulation therapy of 10 minutes a day for 10 consecutive days; Group S2 received electrical stimulation therapy of 10 minutes a day for 20 consecutive days. The peroneal nerve conduction velocity （ NCV ） and compound muscle action potential （ CMAP ） amplitude of extensor digitorum brevis were reviewed 3 months later. The electrophysiological data of three groups before and after treatment were compared. Results： （ 1 ） The NCV of group NS, S1 and S2 were increased by 3.7 ± 2.4m/s, 7.5± 4.3m/s and 7.5± 3.1m/s respectively. Compared with group NS, the NCV of group S1 and S2 were increased （P〈0.05） . Compared with group S1, the NCV of group S2was not increased （P 〉 0.05 ） . （ 2 ） Compared with group NS, the CMAP amplitude of group S1 and S2 were increased by 2.7± 1.8mv, 4.1 ± 1.9my and 5.3 ±2.0mv respectively. Compared with group NS, the CMAP amplitude of group S1 and S2 were increased （P〈0.05） . Compared with group Sl, the CMAP amplitude of group S2 was increased （P〈0.05） . Conclusion： （ 1 ） Transeutaneous electrical nerve stimulation therapy plays a significant role in promoting the function of peripheral nerve with incomplete injury, which represents faster NCV and increased CMAP amplitude. （ 2 ） The prolonged treatment course of transcutaneous electrical nerve stimulation is conducive to nerve function recovery.