术中术后规范化电刺激治疗腓总神经麻痹的疗效分析

Efficacy ana lysis of standardized electrical stimulation in the treatment of common peroneal nerve palsy during and after operation

目的探查术中术后规范化电刺激治疗腓总神经麻痹的疗效。方法收集2015年1月-2019年12月在武陟县人民医院分院骨科接受治疗的腓总神经麻痹患者73例,给予手术松解腓总神经,术中使用双极电凝笔连接神经电刺激仪,以2Hz脉冲,强度100-200,刺激10min,缝合切口前取明胶海绵半片,喷洒5mg地塞米松注射液后贴在腓总神经上。术后2周开始规范化神经电刺激治疗,直至神经功能完全恢复正常。刺激穴位为阳陵泉、足三里。上巨虚、下巨虚,冲阳、解溪、三阴交、阴陵泉。每日1次,每次治疗30min,10天为一疗程,疗程间休息2天。结果全部病例完成至少1年随访,有17例术后一周内肌力增加1个等级,术后1个月随访时有35例肌力增加至少1个等级,术后2个月随访时有50例肌力增加至少1个等级,术后3个月除2例外其余病例均肌力增加至少1个等级。术后3个月复查共27例肌力完全恢复正常,术后6个月时为57例。仅有7例术后1年内肌力未恢复至完全正常,其中3例随访至18个月时神经功能基本恢复,1例随访至2年神经功能未能完全恢复并停止随访,另3例失去随访。结论腓总神经麻痹手术松解时给与电刺激,符合术后规范化电刺激,可以取得满意疗效。

0bjective To explore the fficacy of standardized electrical stimulation in the treatment of common peroneal nerve palsy during and after surgery.Methods A ollection of 73 patients with common peroneal nerve palsy who were treated in the Department of Orthopedies,W uzhi County People's Hospital from January 2015 to December 2019,were operated on to release the common peroneal nerve,and a bipolar electrocoagulation pen was used to connect the nerve electrical stimulation during the operation.Using a 2Hz pulse,intensity 100-200,stimulation for 10 minutes,lake a half piece of gelatin sponge before suture the incision,spray 5mg dexamethasone injection and stick it on the common peroneal nerve.Standardized nerve electrical stimulation treatment was started 2 weeks after the operation until the nerve function completely returned to normal.The stimulation points are Yanglingquan,Zusanli,Shangjuxu,Xiajuxu,Chongyang,Xiexi,Sany injao,and Yinlingquan.Once a day,each treatment is 30 minules,10 days is a course of trealment,and there are 2 days of rest between treatments.Results AlI cases completed at least 1 year ollw-up.There were 17 cases whose muscle strength increased by 1 grade within one week after operation,35 cases had muscle strength increase by at least 1 grade al 1 month postoperative follow-up,and 50 cases al 2 months postoperative follow-up.The muscle strengh of the patients increased by at least 1 grade,and the muscle strength of the rest of the cases was inereased by al least 1 grade 3 months afer the operation,except for 2 exceptions.A lolal of 27 cases of muscle strengh relumed to normal al 3 months after operation,and 57 cases at 6 months after operation.Only 7 cases of muscle strength did not return to complete normal within1 year after operation,of which 3 cases were followed up to 18 months,neurological function basically recovered,1 cease of neurological funetion failed to fully recover after 2 years of ollwup,and the fllow-up was stopped,and the other 3 cases lost Follow up.Conclus ion Electrical stimulation is given during surgical release of common peroneal nerve palsy,which conforms to postoperative standardized electrical stimulation and can achieve satisfactory results.