超声联合肌电图检查在妊娠相关下腰痛康复评价中的应用

Application of ultrasound combined with electromyography in the rehabilitation evaluation of pregnancy-related low back pain

目的探讨超声联合肌电图(EMG)检查在妊娠相关下腰痛(PLBP)康复评价中的应用。方法选取2019年3月至2021年4月于江西医学高等专科学校第一附属医院确诊的30例PLBP的自然分娩初产妇(产后6周)作为观察组,另选取30名无PLBP的未育妇女作为对照组。比较两组左侧、右侧腹直肌厚度,多裂肌及竖脊肌面积,前屈抬腿(侧腹直肌)和后伸飞燕式(多裂肌及竖脊肌)A、B电极RMS值,分析观察组恢复情况,采用Pearson相关性分析超声和肌电图指标与疗效的相关性。结果观察组左、右侧腹直肌放松厚度及左侧收缩厚度均薄于对照组,左、右放松多裂肌及竖脊肌面积均大于对照组,差异有统计学意义(P<0.05)。观察组两侧腹直肌、多裂肌及竖脊肌A、B电极RMS值均低于对照组,差异有统计学意义(P<0.05)。治疗后3、6个月ODI评分低于治疗前,差异有统计学意义(P<0.05)。Pearson相关分析显示,ODI评分与腹直肌厚度、表面肌电图RMS值呈负相关,与多裂肌及竖脊肌面积呈正相关(P<0.05)。结论超声联合EMG检查可了解患者腹肌厚度情况,对PLBP康复评价具有一定应用价值。

Objective To explore the application of ultrasound combined with electromyography(EMG)in the rehabilitation evaluation of preg-nancy-related low back pain(PLBP).Methods A total of 30 primiparas with PLBP symptoms diagnosed in the First Affiliated Hospital of Jiangxi Medical College from March 2019 to April 2021 were selected as the observation group,and 30 nulliparous women without PLBP were selected as the control group.The thickness of the left and right rectus abdominis muscle,the area of the multifidus muscle and the vertical spine muscle,and the RMS values of the A and B electrodes of the forward flexion leg lift(lateral rectus abdominis muscle)and the backward extension flapper(multifidus muscle and the vertical spine muscle)were compared between the two groups,and the recovery of the observation group was analyzed,Pearson cor-relation analysis was used to analyze the correlation between ultrasound and EMG indicators and the curative effect.Results The relaxation thick-ness of left and right rectus abdominis muscle,left side shrinkage thickness in the observation group were thinner than those in the control group,the area of left and right relaxed multifidus muscle and erector spine muscle were larger than those in the control group,and the differences were statisti-cally significant(P<0.05).The RMS values of A and B electrodes in both rectus abdominis,multifidus muscle and erector spine muscle in the obser-vation group were lower than those in the control group,and the difference was statistically significant(P<0.05).At 3 and 6 months after treatment,ODI scores in the observation group were lower than those before treatment,and the differences were statistically significant(P<0.05).Pearson cor-relation analysis showed that ODI score was negatively correlated with rectus abdominis thickness and RMS value of surface electromyography,and positively correlated with the area of multifidus muscle and erector spine muscle(P<0.05).Conclusion Ultrasound combined with EMG examina-tion can understand abdominal muscle thickness of patients,and has a certain application value in the rehabilitation evaluation of pregnancy-related low back pain.