Effects of routine rehabilitation therapy combined with low frequency electrical stimulation on monoamine neurotransmitters, NSE, ET-1 and cerebral hemodynamics in children with cerebral palsy

Objective:To investigate the effects of routine rehabilitation therapy combined with low frequency head stimulation on monoamine neurotransmitters, neuron-specific enolase (NSE), endothelin-1 (ET-1) and cerebral hemodynamics in children with cerebral palsy.Methods:From January 2017 to June 2018, 110 children with cerebral palsy were randomly divided into observation group (55 cases) and control group (55 cases). The control group received routine rehabilitation treatment, while the observation group received low-frequency head stimulation on the basis of routine rehabilitation treatment. The changes of dopamine (DA), norepinephrine (NE), serotonin (5-HT), NSE, ET-1 levels and mean blood flow velocity of anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA) were compared in two groups.Results:Before treatment, there was no significant difference in DA, NE and 5-HT levels in two groups. After treatment, DA, NE and 5-HT levels in the observation group were (192.23±22.71) ng/mL, (98.02±11.71) ng/L, (210.07±25.03) ng/L, and in the control group. the DA, NE, 5-HT levels were (147.06±17.02) ng/mL, (83.07±11.15) ng/L, and (171.88±20.45) ng/L, respectively. The DA, NE and 5-HT levels in two groups were higher than those before treatment, and DA, NE and 5-HT levels in the observation group were higher than those in the control group. Before treatment, there was no significant difference in NSE and ET-1 levels between the two groups. After treatment, the NSE and ET-1 levels in the observation group were (7.97±2.07) μg/L and (41.01±10.07) pg/mL, and the NSE and ET-1 levels in the control group were (10.38±3.02) μg/L, (58.46±15.02) pg/mL, respectively. the NSE and ET-1 in two groups were lower than those before treatment, and the NSE and ET-1 of the observation group were lower than the control group. Before treatment, there was no significant difference in mean blood flow velocity between ACA, MCA and PCA. After treatment, the mean blood flow velocities of ACA, MCA, and PCA in the observation group were (46.88±7.72) cm/s, (59.85±10.18) cm/s, and (49.15±7.02) cm/s, respectively, which was significantly higher than before treatment and higher than that of the control group in the same period.Conclusion: Conventional rehabilitation combined with low-frequency electrical stimulation of the head can effectively increase the content of monoamine neurotransmitters in children with cerebral palsy, enhance cerebral blood circulation, and reduce brain damage.

Effects of cervical low-frequency electrical stimulation with various waveforms and densities on body mass,liver and kidney function,and death rate in ischemic stroke rats

Low-frequency electrical stimulation has resulted in favorable effects in the treatment of post-stroke dysphagia. However, the safety of cervical low-frequency electrical stimulation remains unclear because of numerous nerves and blood vessels in the neck. In the present study, rats with ischemic stroke underwent low-frequency electrical stimulation, and systemic and local effects of electrical stimulation at different densities and waveforms were investigated. Electrical stimulation resulted in no significant effects on body mass, liver or kidney function, or mortality rate. In addition, no significant adverse reaction was observed, despite overly high intensity of low-frequency electrical stimulation, which induced laryngismus, results from the present study suggested that it is safe to stimulate the neck with a low-frequency electricity under certain intensities.

Effects of low frequency electrical stimulation on monoamine neurotransmitters,cerebral blood flow and hemorheology in children with cerebral palsy

Objective: To investigate the effects of low frequency electrical stimulation on monoamine neurotransmitters, cerebral blood flow and hemorheology in children with cerebral palsy. Methods: A total of 83 children with cerebral palsy were divided into the control group (n=42) and the observation group (n=41) according to the random data table, patients in the control group were treated with routine rehabilitation treatment, on this basis;the children in the observation group were treated with low-frequency electric stimulation. Before and after the treatment, the levels of monoamine neurotransmitter [dopamine (DA) and 5-hydroxy tryptamine (5-HT) and norepinephrine (NE)], cerebral blood flow [the average blood flow velocity of anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA)] and blood rheology index [high/low shear whole blood viscosity, plasma viscosity and fibrinogen (FIB)] of two groups were compared. Results: Before treatment, there were no significant difference of the levels of DA, 5-HT, NE, the average blood flow velocity of ACA/MCA/PCA, high/low shear whole blood viscosity, plasma viscosity and FIB between the two groups. After treatment, two groups of DA, 5-HT and NE levels were significantly higher than those in the same group before treatment, and the observation group of DA, 5-HT and NE levels were significantly higher than those of the control group, the difference was statistically significant;The average blood flow rate of ACA/MCA/PCA in the observation group after treatment was significantly higher than those in the same group before treatment;After treatment, the levels of high shear/low shear blood viscosity, plasma viscosity and FIB of the two groups were significantly lower than those in the same group before treatment, and the levels of observation group after treatment were significantly lower than that in the control group, the difference was statistically significant. Conclusion: Low frequency electrical stimulation can effectively increase the level of monoamine neurotransmitter, improve the level of cerebral blood flow and hemorheology, has an important clinical value.

Changes in plasma calcitonin gene-related peptide and serum neuron specific enolase in rats with acute cerebral ischemia after low-frequency electrical stimulation with different waveforms and intensities

Following acute cerebral ischemia in rats, plasma calcitonin gene-related peptide decreased and the level of serum neuron specific enolase and the volume of the infarction increased. Square-wave and triangular-wave electrical stimulation with low or high intensities could increase the plasma calcitonin gene-related peptide, decrease the serum neuron specific enolase and reduce the infarction volume in the brain in rats with cerebral ischemia. There was no significant difference between different wave forms and intensities. The experimental findings indicate that low-frequency electrical stimulation with varying waveforms and intensities can treat acute cerebral ischemia in rats.

Effect of Unilateral Low-Frequency Stimulation of Hippocampus on Rapid Kindling—Induced Seizure Development in Rats

Since the last decade deep brain stimulation has been proposed as an alternative treatment for patients who do not become seizure-free with the current pharmacological treatments and cannot undergo resective surgical procedure. However, the optimal stimulation parameters remain undetermined and active research in humans and animals is necessary. The present study was designed to investigate the effect of unilateral Low Frequency Stimulation (LFS) of hippocampus on seizure development by using the hippocampal rapid kindling method (hRK) in rats. We used male Wistar rats implanted with electrodes in the ventral hippocampus. All rats underwent hRK (biphasic square wave pulses, 20 Hz for 10 seconds) during three consecutive days (twelve stimulations per day). The control group (hRK;n = 6) received only RK stimulus, while the treated group (LFS-hRK;n = 8) received also LFS (biphasic square wave pulses, 1 Hz for 30 seconds) immediately before the RK stimulus, during three consecutive days. At the end of behavioral testing on day 3, 62% (P < 0.05) of the animals receiving LFS treatment were still not fully kindled staying in stages 0-III (P < 0.01). The number of stimulations needed to achieve generalized seizures (stage IV-V of Racine scale) was significantly higher (P < 0.05) in the LFS group with respect to control group. No significant differences in the cumulative daily afterdischarge duration were observed between both groups. These findings suggest that preemptive LFS can significantly decrease the incidence of hippocampus-kindled seizures and delay the progression and secondary generalization of focal seizures.

Electrical stimulation upregulates angiopoietin-1/Tie-2 mRNA expression in a rat model of focal cerebral ischemia

Angiopoietin-1/tyrosine kinase with immunoglobulin and epidermal growth factor homology domains 2 （Tie-2） is a newly discovered signaling pathway of angiogenesis. Angiogenesis benefits recovery of neurological functions such as swallowing. In the present study, a rat model of dysphagia following stroke was induced by middle cerebral artery occlusion to investigate the influence of low frequency electrical stimulus with bidirectional square waves and triangular waves on angiopoietin-1/-13e-2 mRNA expression. Reverse transcription-polymerase chain reaction results showed that low frequency electrical stimulus significantly improved the neurological scores of the model rats, and increased angiopoietin-1/＇13e-2 mRNA expression. This demonstrates that low frequency electrical stimulation can ameliorate neurological function in rats with focal brain ischemia, potentially through regulation of angiopoietin-1/-13e-2 expression in the angiogenesis pathway.

Hippocampal High-Frequency Stimulation Inhibites the Progression of Rapid Kindling-Induced Seizure in Rats

Epilepsy is one of the most common serious neurological disorders. Pharmacoresistant epilepsy patients are poorly controlled or their seizures are refractory to drug treatment. Resective surgery is frequently a promising therapy in this population, however, not all the patients meet the eligibility criteria for the surgical treatment. Deep brain stimulation has been investigated in clinical studies and animal studies as an alternative treatment, but the optimal stimulation parameters remain an issue. The present study was designed to investigate the effect of unilateral high-frequency stimulation (HFS) of hippocampus on seizure development by using the hippocampal rapid kindling method (hRK) in rats, and compared the results with those of low-frequency stimulation previously published by our group. We used male Wistar rats implanted with electrodes in the ventral hippocampus. All rats underwent hRK (biphasic square wave pulses, 20 Hz for 10 seconds) during three consecutive days (twelve stimulations per day). The control group (hRK;n = 7) received only RK stimulus, while the treated group (HFS-hRK;n = 9) received also HFS (biphasic square wave pulses, 130 Hz for 30 seconds) immediately before the RK stimulus, during three consecutive days. At the end of behavioral testing 78% (p 0.01) of the animals receiving HFS treatment were still not fully kindled staying in stages 0 -III (p 0.01). HFS group needed a higher number of stimulations to achieve stage III (p 0.05) with respect to control group. However, no significant differences in the cumulative daily afterdischarge duration were observed. HFS did not present significant differences compared with LFS in any of studied parameters. The findings suggest that unilateral HFS applied on hippocampus effectively inhibited the epileptogenic process induced by hippocampal rapid kindling. According to the comparative results about hippocampal rapid kindled animals stimulated with HFS and LFS (5 Hz), we found no conclusive information on which treatment is most efficient.

通督调神针刺联合低频脉冲穴位电刺激治疗脑卒中后吞咽障碍(假性球麻痹)临床研究

目的观察通督调神针刺联合低频脉冲穴位电刺激对脑卒中后吞咽障碍(DAS)(假性球麻痹)的临床疗效。方法按随机数字表法将60例DAS(假性球麻痹)患者按入院顺序随机分为治疗组与对照组各30例;两组患者均接受脑卒中西医常规治疗,并统一进行吞咽功能康复训练;对照组予普通针刺法,治疗组予通督调神针刺联合低频脉冲穴位电刺激治疗。所有患者治疗6 d为1个疗程,疗程间休息1 d,共治疗2个疗程。2个疗程后比较两组标准吞咽功能评价量表(SSA)、洼田饮水试验等级评分,并评价两组临床疗效。结果1)两组SSA量表评分在治疗后均较前降低(P<0.05),且治疗组SSA评分比对照组降低更明显(P<0.05)。2)治疗后两组患者洼田饮水试验评分比较,差异有统计学意义(P<0.05)。3)治疗组总有效率为83.33%,显著高于对照组的60.00%(P<0.05)。结论通督调神针刺联合低频脉冲穴位电刺激治疗在降低SSA评分及洼田饮水试验等级评分能力上均优于普通针刺法,可明显改善DAS(假性球麻痹)患者的吞咽功能。

耳穴压籽联合低频电穴位刺激对髋、膝关节术后深静脉血栓形成预防效果观察

[目的]观察耳穴压籽联合低频电穴位刺激对髋、膝关节术后深静脉血栓(DVT)形成预防效果。[方法]选定天津中医药大学第二附属医院2018年8月—2023年8月就诊的120例髋、膝关节手术患者,以随机数字表法随机将其分为2组,各60例,对照组给予利伐沙班治疗,观察组在对照组的基础上给予低频电穴位刺激联合耳穴压籽治疗,两组均在治疗7 d后进行疗效评价,比较两组血栓弹力图(TEG)参数、凝血功能指标、患肢周径差值、患肢肿胀程度、视觉模拟自评量表(VAS)评分、DVT发生率。[结果]观察组治疗后凝血指数(CI)、最大振幅(MA)、血凝块聚合形成速率(α角)均低于对照组,差异有统计学意义(P<0.05),观察组治疗后凝血时间(K)、反应时间(R)均高于对照组,差异有统计学意义(P<0.05)。观察组治疗后D-二聚体(D-D)、纤维蛋白原(FIB)均低于对照组,差异有统计学意义(P<0.05),观察组治疗后部分凝血酶原时间(APTT)、凝血酶原时间(PT)均高于对照组,差异有统计学意义(P<0.05)。观察组治疗后大腿、小腿周径差值均低于对照组,差异有统计学意义(P<0.05)。观察组患肢肿胀程度轻于对照组,差异有统计学意义(P<0.05)。观察组治疗后VAS评分低于对照组,差异有统计学意义(P<0.05)。观察组DVT发生率(1.67%)低于对照组(13.33%),差异有统计学意义(P<0.05)。[结论]耳穴压籽联合低频电穴位刺激可有效改善髋、膝关节手术患者术后凝血功能,缓解肢体肿胀、疼痛等症状,缩小患肢周径差,降低DVT发生率。

低频穴位电刺激联合六步法乳房按摩对剖宫产产妇母乳喂养、泌乳功能和产后心理状态的影响

目的:探讨低频穴位电刺激联合六步法乳房按摩对剖宫产产妇母乳喂养、泌乳功能和产后心理状态的影响。方法:选取2022年9月~2022年12月在我院产科剖宫产分娩的120名产妇为研究对象。随机分为观察组和对照组,各60例。对照组予以六步法乳房按摩,观察组予以低频穴位电刺激联合六步法乳房按摩。采用母乳喂养测量工具(breast-feeding assessment tool,BAT)、母乳喂养自我效能量表(breastfeeding self-efficacy scale,BSES)及产后42d纯母乳喂养率评估母乳喂养情况;记录产妇泌乳始动时间、泌乳量、产后48h乳房胀痛程度及产后24、48、72h血清泌乳素(prolactin,PRL)水平;于产后72h、42d采用爱丁堡产后抑郁量表(edinburgh postnatal depression scale,EPDS)评估产妇产后心理状态。结果:观察组BAT评分、首次母乳喂养成功率、产后42d纯母乳喂养率以及产后72h、42d BSES评分均高于对照组(P<0.05)。观察组产妇泌乳始动时间早于对照组(P<0.05),泌乳量以及产后24、48、72h PRL水平均高于对照组(P<0.05),产后48h乳房胀痛程度低于对照组(P<0.05)。观察组产后72h、42d EPDS评分均低于对照组(P<0.05)。结论:低频穴位电刺激联合六步法乳房按摩可提高剖宫产产妇母乳喂养率和母乳喂养自信心,改善乳房胀痛,促进泌乳功能和产后心理健康,是一种值得推广的产后乳房护理方法。

低频脉冲电刺激联合改良站立位重心转移能力训练在脑卒中后偏瘫康复治疗中的应用效果及对周围神经电生理学的影响

目的探讨低频脉冲电刺激联合改良站立位重心转移能力训练在脑卒中后偏瘫康复治疗中的应用效果及对周围神经电生理学的影响。方法选择2021年2月至2022年3月收治的60例脑卒中后偏瘫患者为研究对象,按照随机数字表法将其分为对照组与观察组,各30例。对照组采取常规康复治疗,观察组在对照组基础上施加低频脉冲电刺激联合改良站立位重心转移能力训练。比较两组的患肢肢体运动功能、步频、步速及周围神经电生理学指标。结果干预后,观察组的上肢与下肢运动功能评分均高于对照组(P<0.05)。干预后,观察组的步频、步速均高于对照组(P<0.05)。干预后,观察组的胫神经与腓总神经运动神经传导速度(MCV)与感觉传导速度(SCV)均高于对照组(P<0.05)。结论低频脉冲电刺激联合改良站立位重心转移能力训练在脑卒中后偏瘫康复治疗中的应用效果满意,可改善上肢与下肢运动功能,促进步态恢复,也能调节周围神经电生理学指标,值得推广。

低频电刺激可缓解妇科开腹手术术后疼痛及促进胃肠功能恢复

目的 观察低频电刺激对妇科腹部手术后患者康复的影响。方法 选择2021年6月至2022年7月间,在蚌埠医学院泰兴临床学院妇产科进行开腹手术的患者63例。将患者随机分成对照组31例和低频电刺激组32例。低频电刺激组予以患者可耐受范围内进行刺激,每日1次,每次30 min,每次刺激强度需重新测定。对照组选取相同穴位处粘贴电极片,连接治疗仪,但不给予电流刺激。30 min后去除电极片。采用视觉模拟评分法(VAS)记录术后评分、手术结束至首次排气排便的时间。结果 术后48 h VAS评分,低频电刺激组(3.6±1.2)vs.对照组(4.5±1.4),疼痛程度降低(P<0.05);术后72 h VAS评分,低频电刺激组(1.7±0.9)vs.对照组(3.3±1.4),疼痛程度降低(P<0.01)。首次排气时间(26.9±6.7)h vs.(35.5±13.0)h低频电刺激组相对对照组时间短(P<0.05);首次排便时间(49.0±5.4)h vs.(64.4±13.8)h低频电刺激组相比对照组时间短(P<0.05)。结论 低频电生理刺激能减轻妇科开腹手术患者术后疼痛;促使患者术后首次排气、排便时间缩短。

针刺八髎穴联合中频刺激治疗脊髓损伤后神经源性膀胱临床疗效及对尿流动力学的影响

目的观察针刺八髎穴联合中频电刺激对脊髓损伤后神经源性膀胱患者的治疗效果,及对其排尿功能、尿流动力学的影响。方法将86例脊髓损伤后神经源性膀胱患者按照随机数字表法分为治疗组和对照组,各43例。2组均予常规膀胱功能训练,对照组加中频刺激治疗,治疗组在对照组基础上加针刺八髎穴。2周为1个疗程,连续治疗2个疗程后统计疗效。比较2组治疗前后排尿情况(包括日均单次排尿量、日均导尿次数、日均漏尿次数)、尿流动力学相关指标(膀胱残余尿量、最大逼尿肌压、最大膀胱测压容积)。结果治疗组总有效率88.37%(38/43),对照组总有效率69.77%(30/43),治疗组总有效率高于对照组(P<0.05)。治疗后2组日均单次排尿量均升高(P<0.05),日均导尿次数、日均漏尿次数均下降(P<0.05);与对照组比较,治疗后治疗组日均单次排尿量上升(P<0.05),日均导尿次数、日均漏尿次数均显著下降(P<0.05)。治疗后2组残余尿量显著减少(P<0.05),最大逼尿肌压、最大膀胱测压容积均显著增加(P<0.05);与对照组比较,治疗后治疗组残余尿量显著减少(P<0.05),最大逼尿肌压、最大膀胱测压容积显著上升(P<0.05)。结论针刺八髎穴联合中频刺激治疗脊髓损伤后神经源性膀胱效果优于中频刺激治疗,能有效改善其排尿功能和尿流动力学。

低频脉冲电刺激联合任务导向康复训练在脑卒中后偏瘫康复治疗中的应用效果及对肢体肌力的影响

目的探讨低频脉冲电刺激联合任务导向康复训练在脑卒中后偏瘫康复治疗中的应用效果及对肢体肌力的影响。方法选取2020年3月至2022年2月于我院就诊的60例脑卒中后偏瘫患者为研究对象,随机将其分为对照组和观察组,各30例。两组患者入院后均给予基础治疗及对症治疗,对照组采用常规康复训练,观察组在对照组基础上加用低频脉冲电刺激联合任务导向康复训练。比较两组的干预效果。结果观察组的肢体肌力恢复总有效率高于对照组(P<0.05)。干预后,观察组的髋关节与膝关节前屈、后伸肌力高于对照组,髋关节与膝关节前屈、后伸肌张力低于对照组(P<0.05)。干预后,观察组的Fugl-Meyer下肢运动功能评分量表(FMA-LE)、Holden步行功能分级量表(FAC)评分及髋关节与膝关节活动度高于对照组(P<0.05)。结论低频脉冲电刺激联合任务导向康复训练用于脑卒中后偏瘫康复治疗中的效果显著,可增强肌力,促进肢体功能及关节活动度恢复,值得推广。

尼麦角林联合低频电刺激治疗对脑卒中后吞咽困难的影响

目的:观察尼麦角林联合低频电刺激治疗对脑卒中后吞咽困难患者及血清神经功能的影响。方法:选取90例脑卒中后吞咽困难患者,随机将患者分成3组,每组30例。A组给予常规治疗;B组给予常规治疗结合尼麦角林;C组给予常规治疗结合尼麦角林和吞咽障碍治疗仪治疗。比较3组患者治疗2周的治疗效果,比较治疗前后美国国立卫生研究院卒中量表(NIHSS)和标准吞咽功能量表(SSA)评分、洼田饮水等级、血清脑源性神经营养因子(BDNF)、神经生长因子(NGF)和神经元特异性烯醇化酶(NSE)变化,以及不良反应发生情况。结果:治疗后,3组患者NIHSS评分、SSA评分及血清NSE水平均较治疗前显著降低(均P<0.05),且B、C组低于A组(P<0.05),C组低于B组(P<0.05);3组洼田饮水试验等级优于治疗前(P<0.05),B、C组优于A组(P<0.05),C组优于B组(P<0.05);3组患者血清BDNF和NGF表达水平及总有效率均较治疗前明显升高(P<0.05),且B、C组高于A组(P<0.05),C组高于B组(P<0.05)。结论:尼麦角林联合低频电刺激治疗可有效治疗脑卒中后吞咽困难患者,升高血清BDNF和NGF水平,降低NSE水平,协助患者恢复吞咽功能,且具有良好的安全性。

不同频率电刺激促进周围神经损伤的恢复

背景:电刺激是治疗周围神经损伤有效的治疗方案,但不同频率电刺激促进周围神经恢复的机制和应用不同。目的:旨在系统梳理和总结不同频率电刺激在周围神经损伤治疗中的作用和应用,深入分析各种方法的优缺点,以期找到最有利于患者神经恢复的治疗策略。方法:应用计算机检索中国知网、PubMed数据库自建库至2024年5月期间的相关文献,英文检索词为“peripheral nerve injury,electrical stimulation,low frequency electrical stimulation,medium frequency electrical stimulation,high frequency electrical stimulation,TENS,interfering electricity,short wave,ultrashort wave,frequency”,中文检索词为“周围神经损伤,电刺激,低频电刺激,中频电刺激,高频电刺激,干扰电疗法,短波,超短波,频率,周围神经再生”,最终纳入74篇文献进行分析。结果与结论:周围神经损伤作为临床中常见的疾病,会引起患者感觉与运动功能障碍。低频电刺激能够促进电刺激后细胞增殖并加速细胞内神经生长因子表达,促进巨噬细胞募集和浸润,加速髓磷脂碎片的清除,促进受损轴突的髓鞘再生。中频电刺激能够作用于更深部位组织,对于缓解神经性疼痛方面更佳。高频电刺激能够促进施万细胞和巨噬细胞增殖并抑制炎性因子,更快募集到神经损伤部位,加快神经修复的速度。不同频率的电刺激在周围神经损伤恢复中各具优点,但是仍存在一些问题,例如电刺激的部位以及应对各种疾病类型的方案不同等。

温针灸联合低频电刺激治疗急性卒中后尿失禁的疗效观察及对尿动力学的影响

目的观察温针灸联合穴位低频电刺激治疗急性卒中后尿失禁的临床疗效及对患者尿动力学的影响。方法将收治的108例急性卒中后尿失禁患者按随机数字表法分为对照组和观察组,每组54例。对照组采用常规留置、间歇清洁、导尿、膀胱训练、药物及穴位低频电刺激治疗,观察组在对照组治疗基础上联合温针灸治疗。比较两组临床疗效和72 h排尿情况,观察治疗前和治疗后两组国际尿失禁咨询委员会问卷简表(International Consultation on Incontinence questionnaire-short form,ICIQ-SF)、生存质量(quality of life,QOL)和国际下尿路综合征症状(lower urinary tract symptoms,LUTS)的评分变化以及尿动力学指标水平的变化。结果观察组总有效率为98.1%,高于对照组的85.2%(P<0.05)。治疗后,两组72 h排尿情况、尿动力学指标、ICIQ-SF评分、QOL评分和LUTS评分均优于同组治疗前(P<0.05),且观察组上述观察指标结果均优于对照组(P<0.05)。结论在常规治疗基础上,温针灸联合穴位低频电刺激治疗急性卒中后尿失禁可提高临床疗效,改善患者尿动力学指标和尿失禁的情况。

电针结合低频电刺激对脑卒中偏瘫患者下肢功能的影响及重建效果相关因素分析

目的:探讨电针结合低频电刺激对脑卒中偏瘫患者下肢功能的影响,分析下肢功能重建效果的影响因素,并研究相关护理对策。方法:选取2022年1月1日~2023年1月31日收治的162例脑卒中偏瘫患者为研究对象,均接受电针结合低频电刺激干预,连续干预4周。采用Fugl-Meyer运动功能量表(FMA)评估患者下肢功能重建效果,并收集患者临床资料,比较不同临床资料脑卒中偏瘫患者FMA评分,分析影响患者下肢功能重建的相关因素,制订护理对策。结果:干预4周后,162例患者FMA评分高于干预前(P<0.05);年龄≥60岁、入院时美国国立卫生研究院卒中量表(NIHSS)评分≥21分、合并糖尿病、未结合规律性运动康复训练的脑卒中偏瘫患者干预4周后FMA评分分别低于年龄<60岁、入院时NIHSS评分<21分、未合并糖尿病、结合规律性运动康复训练的患者(P<0.05);经多元线性回归分析显示,年龄≥60岁、入院时NIHSS评分≥21分、合并糖尿病是脑卒中偏瘫患者下肢功能重建效果的危险因素(P<0.05),结合规律性运动康复训练是保护因素(P<0.05);经相关性分析显示,脑卒中偏瘫患者下肢功能重建效果与年龄、入院时NIHSS评分、糖尿病合并情况呈负相关(P<0.05),与结合规律性运动康复训练呈正相关(P<0.05)。结论:电针结合低频电刺激对改善脑卒中偏瘫患者下肢功能具有积极意义,其下肢功能重建效果可能与患者年龄、入院时NIHSS评分、糖尿病合并情况、是否结合规律性运动康复训练有关。

CTAR联合吞咽低频电刺激治疗CS后DAS患者的效果

目的探讨下颏抗阻力训练(chin tuck against resistance,CTAR)联合吞咽低频电刺激治疗脑卒中(cerebral stroke,CS)后吞咽障碍(dysphagia after actue stroke,DAS)患者的疗效。方法采用配对病例对照研究法选取虞城县人民医院康复科2021年1月至2023年9月收治的84例CS后DAS患者进行回顾性研究,按治疗方案不同分为参照组(n=42)、研究组(n=42)。其中采用吞咽低频电刺激治疗的患者设为参照组,采用CTAR联合吞咽低频电刺激治疗的患者设为研究组。比较两组治疗前、治疗4周后吞咽功能障碍分级情况、标准吞咽功能评定量表(SSA)评分、功能性经口舌摄食量表(FOIS)评分、舌骨喉活动度、表面肌电图、吞咽障碍特异性生命质量量表(SWAL-QOL)评分。结果研究组治疗4周后吞咽功能障碍改善情况优于参照组(P<0.05);研究组治疗4周后SSA评分为(24.18±2.12)分,低于参照组(28.79±3.77)分,FOIS评分为(5.68±0.45)分,高于参照组(4.63±0.51)分(P<0.05);研究组治疗4周后舌骨前移、上移活动度分别为(11.47±2.55)mm、(17.38±4.59)mm,高于参照组(8.25±1.06)mm、(14.03±4.56)mm(P<0.05);研究组治疗4周后最大波幅为(725.38±55.02)V,高于参照组(605.98±49.65)V,吞咽时程为(1.11±0.15)s,短于参照组(1.33±0.21)s(P<0.05);研究组治疗4周后SWAL-QOL评分为(125.32±15.32)分,高于参照组(102.54±14.25)分(P<0.05)。结论CTAR联合吞咽低频电刺激治疗CS后DAS患者可有效提高舌骨喉活动度,改善吞咽、摄食功能,促进生活质量提升。

低频电刺激联合穴位贴敷对人工流产术后子宫康复效果及月经恢复时间的影响观察

目的探究对人工流产术后患者给予低频电刺激联合穴位贴敷治疗的有效性,并观察对其子宫康复效果、月经恢复时间的影响。方法选取70例人工流产术患者,根据电脑随机法将其分成对照组和观察组,每组35例。对照组将低频电刺激作为治疗方案,观察组将低频电刺激联合穴位贴敷作为治疗方案。比较两组治疗前后性激素(血清人绒毛膜促性腺激素、孕酮以及雌二醇)、子宫血流动力学指标[搏动指数(PI)、阻力指数(RI)、收缩期峰值血流与舒张期末流速比(S/D)]及康复效果、月经恢复时间、子宫内膜厚度。结果两组治疗后血清人绒毛膜促性腺激素、孕酮以及雌二醇水平较同组治疗前均降低,且观察组血清人绒毛膜促性腺激素(153.78±31.40)mIU/ml、孕酮(15.16±3.14)ng/ml以及雌二醇(56.47±9.63)pg/ml低于对照组的(188.69±36.21)mIU/ml、(17.14±4.05)ng/ml、(60.75±5.29)pg/ml,差异有统计学意义(P<0.05)。两组治疗后子宫内膜螺旋动脉RI、PI、S/D较本组治疗前均降低,且观察组子宫内膜螺旋动脉RI(0.51±0.10)、PI(0.75±0.11)、S/D(2.18±0.17)低于对照组的(0.59±0.06)、(0.86±0.19)、(2.43±0.21),差异有统计学意义(P<0.05)。观察组康复总有效率91.43%高于对照组的71.43%,差异有统计学意义(P<0.05)。观察组月经恢复时间以及子宫内膜厚度均优于对照组,差异有统计学意义(P<0.05)。结论临床将低频电刺激联合穴位贴敷应用于人工流产术后方法可行,其能够改善患者性激素、子宫血流动力学,提升子宫康复效果,促进月经早日恢复。