神经肌肉电刺激联合作业疗法在小儿臂丛神经损伤康复治疗中的应用

Application of Neuromuscular Electrical Stimulation Combined with Occupational Therapy in Rehabilitation of Brachial Plexus Injury in Children

目的:探讨神经肌肉电刺激联合作业疗法在小儿臂丛神经损伤(BPI)康复治疗中的应用效果。方法:选取2016年6月-2021年6月吉安市妇幼保健院收治的80例小儿BPI患儿,按随机数字表法将其分为对照组和观察组,每组40例。两组患儿均进行基础康复训练,对照组行作业疗法,观察组行神经肌肉电刺激仪联合作业疗法。比较两组肩关节活动度、Constant-Murley肩关节评分、臂丛神经损伤功能障碍(OBPIF)评分、运动神经传导速度及临床疗效。结果:观察组总有效率为92.50%,高于对照组的75.00%,差异有统计学意义(P<0.05)。治疗后,观察组前屈上举、外展上举、后伸、外旋、内旋、内收活动度均高于对照组(P<0.05)。治疗后,观察组OBPIF评分、Constant-Murley评分均高于对照组(P<0.05)。治疗后,观察组腋神经传导速度和正中神经传导速度均快于对照组(P<0.05)。结论:神经肌肉电刺激联合作业疗法是治疗BPI患儿的有效方法,能改善其肩关节活动功能,加快臂丛神经传导速度,减轻臂丛神经损伤。

Objective:To investigate the application of neuromuscular electrical stimulation combined with occupational therapy in the rehabilitation of brachial plexus injury (BPI) in children.Method:A total of 80 children with BPI admitted to the Matemity and Child Health Hospital of Ji’an from June 2016 to June 2021 were selected,they were divided into control group and observation group according to the random number table method,with 40 cases in each group.Both groups were given basic rehabilitation training,the control group received occupational therapy,the observation group received neuromuscular electrical stimulation combined with occupational therapy.The shoulder range of motion,Constant-Murley shoulder scores,brachial plexus injury dysfunction (OBPIF) scores,motor nerve conduction velocity and clinical efficacy were compared between the two groups.Result:The total effective rate in the observation group was 92.50%,which was higher than 75.00% in the control group,the difference was statistically significant (P<0.05).After treatment,the forward flexion and lifting,abduction and lifting,extension,external rotation,internal rotation and adduction activities in the observation group were higher than those in the control group (P<0.05).After treatment,the scores of OBPIF and Constant-Murley in the observation group were higher than those in the control group (P<0.05).After treatment,the axillary nerve conduction velocity and median nerve conduction velocity in the observation group were faster than those in the control group (P<0.05).Conclusion:Neuromuscular electrical stimulation combined with occupational therapy is an effective method for the treatment of children with BPI,which can improve the mobility of shoulder joint and accelerate the conduction velocity of brachial plexus nerve,reduce brachial plexus nerve injury.