Effect of low-frequency pulse percutaneous electric stimulation on peripheral nerve injuries at different sites

BACKGROUND： The postoperative recovery of nerve function in patients with peripheral nerve injury is always an important problem to solve after treatment. The electric stimulation induced electromagnetic field can nourish nerve, postpone muscular atrophy, and help the postoperative neuromuscular function. OBJECTIVE： To observe the effects of low-frequency pulse percutaneous electric stimulation on the functional recovery of postoperative patients with peripheral nerve injury, and quantitatively evaluate the results of electromyogram （EMG） examination before and after treatment. DESIGN ： A retrospective case analysis SETTING： The Sixth People＇s Hospital affiliated to Shanghai Jiaotong University PARTICIPANTS： Nineteen postoperative inpatients with peripheral nerve injury were selected from the De- partment of Orthopaedics, the Sixth People＇s Hospital affiliated to Shanghai Jiaotong University from June 2005 to January 2006, including 13 males and 6 females aged 24-62 years with an average of 36 years old. There were 3 cases of brachial plexus nerve injury, 3 of median nerve injury, 7 of radial nerve injury, 3 of ul- nar nerve injury and 3 of common peroneal nerve injury, and all the patients received probing nerve fiber restoration. Their main preoperative manifestations were dennervation, pain in limbs, motor and sensory disturbances. All the 19 patients were informed with the therapeutic program and items for evaluation. METHODS： ① Low-frequency pulse percutaneous electric stimulation apparatus： The patients were given electric stimulation with the TERESA cantata instrument （TERESA-0, Shanghai Teresa Health Technology, Co., Ltd.）. The patients were stimulated with symmetric square waves of 1-111 Hz, and the intensity was 1.2-5.0 mA, and it was gradually adjusted according to the recovered conditions of neural regeneration following the principle that the intensity was strong enough and the patients felt no obvious upset. They were treated for 4- 24 weeks, 10-30 minutes for each time, 1-3 times a day, and 6 weeks as a course. ② EMG examination was applied to evaluate the recoveries of recruitment, motor conduction velocity （MCV） and sensory conduction velocity （SCV） before and after treatment. The patients were examined with the EMG apparatus （DIS- A2000C, Danmark） before and after the treatment of percutaneous electric stimulation. ③Standards for evaluating the effects included cured （complete recovery of motor functions, muscle strength of grade 5, no abnormality in EMG examination）, obviously effective [general recovery of motor function, muscle strength of grade 4, no or a few denervation potentials, motor conduction velocity （MCV） and sensory conduction velocity （SCV）], improved （partial recovery of motor function, muscle strength of grade 3, denervation potentials and reinneration potentials, slowed MCV and SCV, invalid （no obvious changes of motor function）. MAIN OUTCOME MEASURES： ① Ameliorated degree of the nerve function of the postoperative patients with peripheral nerve injury treated with percutaneous electric stimulation; ② Changes of EMG examination before and after treatment. RESULTS： All the 19 postoperative patients with peripheral nerve injury were involved in the analysis of results. ① Comparison of nerve function before and after treatment in 19 patients with peripheral nerve injury of different sites： For the patients with radial nerve injury （n=7）, the nerve functions all completely recovered after 8-week treatment, and the cured and obvious rate was 100% （7/7）; For the patients with brachial plexus nerve injury （n=3）, 1 case had no obvious improvement, and the cured and obvious rate was 67% （2/3）; For the patients with common peroneal nerve injury （n=3）, the extension of foot dorsum generally recovered in 1 case of nerve contusion after 4-week treatment, and the cured and obvious rate was 67% （2/3）; For the patients with median nerve injury （n=3）, muscle strength was obviously recovered, and the cured and obvious rate was 100% （3/3）; For the patients with ulnar nerve injury （n=3）, 1 case only had recovery of partial senses, and the cured and obvious rate was 67% （2/3）. Totally 9 cases were cured, 7 were obviously effective, 1 was improved, and only 2 were invalid. After 4 courses, the cured rate of damaged nerve function after four courses was 47% （9/19）, and effective rate was 89% （17/19）.② Comparison of EMG examination before and after treatment： Before and after percutaneous electric stimulation, he effective rates of recruitment, MCV and SCV were 89% （17/19）, 58% （11/19）, 47% （9/19） respectively, and there were extremely obvious differences （P〈 0.01）. CONCLUSION： ①Low-frequency pulse percutaneous electric stimulation can improve the nerve function of postoperative patients with peripheral nerve injury of different sites, especially that the injuries of radial nerve and median nerve recover more obviously. ②Percutaneous electric stimulation can ameliorate the indexes of EMG examination, especially the recruitment, in postoperative patients with peripheral nerve injury.

Kegel训练联合低频脉冲反馈电刺激 治疗盆底功能障碍性疾病的临床效果分析

目的:探究Kegel训练联合低频脉冲反馈电刺激治疗盆底功能障碍性疾病的临床效果。方法:选择2022年1月—2023年2月邵东市两市塘街道社区卫生服务中心收治的108例盆底功能障碍性疾病患者作为研究对象,按照抽签法随机分为对照组(采取Kegel训练)、观察组(在对照组基础上实施低频脉冲反馈电刺激),各54例。对比两组治疗效果。结果:治疗前,两组盆底肌力分级情况比较,差异无统计学意义(P>0.05);治疗后,观察组盆底肌肌力分级情况优于对照组(P<0.05)。治疗前,两组盆底Ⅰ、Ⅱ类肌纤维肌电压值与疲劳度比较,差异无统计学意义(P>0.05);治疗后,两组盆底Ⅰ、Ⅱ类肌纤维肌电压值提高,肌疲劳度下降,且观察组改善幅度大于对照组(P<0.05)。治疗前,两组女性性功能指数量表(FSFI)评分比较,差异无统计学意义(P>0.05);治疗后,两组FSFI评分升高,且观察组高于对照组(P<0.05)。结论:Kegel训练联合低频脉冲反馈电刺激治疗盆底功能障碍性疾病的临床效果优于单纯Kegel训练,能够改善患者盆底肌力,增强盆底功能,提升性生活质量。

三阴交穴位按摩联合低频脉冲反馈电刺激对产后压力性尿失禁患者盆底功能、尿失禁次数的影响

目的探究三阴交穴位按摩联合低频脉冲反馈电刺激对产后压力性尿失禁患者盆底功能、尿失禁次数的影响。方法选取2018年6月—2020年6月期间在南京中医药大学太仓附属医院进行产后压力性尿失禁治疗的患者110例,根据随机数字表法分为按摩组和联合组,每组各55例。两组患者均进行常规治疗,适当减少水分摄入,及时排尿,进行膀胱功能训练,按摩组在常规治疗的基础上进行三阴交穴位按摩治疗,联合组在按摩组的基础上,进行低频脉冲反馈电刺激治疗。治疗6周后,观察比较两组患者临床疗效,治疗前后尿流动力学指标[腹压漏尿点压力(Abdominal leak point pressure,ALPP)、最大尿流率(The maximum flow rate,Qmax)、最大尿道闭合压(Maximum urethral closure pressure,MUCP)];膀胱颈活动度、尿道旋转角水平;盆底功能水平(阴道收缩压、阴道静息压、阴道收缩持续时间);ICI-Q-SF评分(总排尿量、总排尿次数、总漏尿次数、总分)。结果治疗后两组患者尿流动力学指标ALPP、Qmax、MUCP水平较治疗前升高,差异有统计学意义(P<0.05),且联合组高于按摩组,差异有统计学意义(P<0.05)。治疗后两组患者膀胱颈活动度、尿道旋转角水平较治疗前降低,差异有统计学意义(P<0.05);且联合组低于按摩组,差异有统计学意义(P<0.05)。治疗后两组患者阴道收缩压、阴道静息压、阴道收缩持续时间水平较治疗前升高,差异有统计学意义(P<0.05);且联合组高于按摩组,差异有统计学意义(P<0.05)。治疗后两组患者ICI-Q-SF评分总分及总排尿次数、总漏尿次数较治疗前降低,总排尿量较治疗前升高,差异有统计学意义(P>0.05);且联合组ICI-Q-SF评分总分及总排尿次数、总漏尿次数低于按摩组,总排尿量高于按摩组,差异有统计学意义(P<0.05)。治疗后联合组临床疗效总有效率92.73%(51/55)明显高于按摩组70.91%(39/55),差异有统计学意义(P<0.05)。结论经三阴交穴位按摩联合低频脉冲反馈电刺激联合治疗后,产后压力性尿失禁患者尿流动力学指标水平提高,盆底功能改善,ICI-Q-SF评分降低,尿失禁症状明显减轻,联合治疗效果显著。

低频脉冲反馈电刺激联合盆底功能康复训练对预防盆底功能障碍的影响

目的探讨低频脉冲反馈电刺激联合盆底功能康复训练对预防盆底功能障碍的影响。方法将188例足月阴道分娩产妇回顾性分成研究组和对照组各94例。对照组予以产后盆底功能康复训练方案,研究组在对照组基础上联合低频脉冲反馈电刺激治疗。观察比较两组产妇产后6个月时盆底肌力分级、性功能[女性性功能评分量表(FSFI)]评估结果及尿动力学指标[最大尿流率(Qmax)、尿流时间(VT)、最大尿道压(MUP)]检测结果差异,记录其产后6个月内盆底功能障碍、性功能障碍、尿失禁发生情况。结果研究组产妇中途失联2例,对照组产妇中途失联4例(P>0.05)。产后6个月时,研究组产妇盆底肌力分级正常率、Qmax、MUP检测结果均明显高于对照组(P<0.05),FSFI评分也明显高于对照组[(88.7±5.3)分vs(72.8±4.8)分,P<0.05],VT水平及产后盆底功能障碍、性功能障碍、尿失禁等发生率则明显低于对照组,差异均有显著性(P<0.05)。结论产后予以低频脉冲反馈电刺激联合盆底功能康复训练干预,对促进产妇盆底功能、性功能及泌尿功能恢复具有积极意义。

引导式教育训练联合低频脉冲反馈电刺激对产后早期盆底功能康复及盆底肌肉张力的影响

目的研究引导式教育训练联合低频脉冲反馈电刺激对产后早期盆底功能康复及盆底肌肉张力的影响。方法选取2019年1月至2020年7月本院接诊的78例足月阴道分娩产妇作为研究对象,按接诊时间分为研究组与对照组,每组39例。对照组行常规产后康复训练,研究组在对照组基础上行引导式教育训练联合低频脉冲反馈电刺激,比较两组干预前后盆底肌肉恢复情况、尿动力学指标及预后情况。结果研究组产后盆底肌分级正常率明显高于对照组(P<0.05);干预后,两组产妇阴道收缩压均高于干预前,收缩时间均长于干预前,且研究组产妇阴道收缩压高于对照组,收缩时间长于对照组(P<0.05);研究组最大尿流率(Qmax)、最大尿道压(MUP)水平明显高于对照组,尿流时间(VT)明显短于对照组(P<0.05);研究组产后并发症发生率显著低于对照组(P<0.05)。结论联合应用引导式教育训练与低频脉冲反馈电刺激有助于促进产妇产后盆底功能康复,改善泌尿功能,减少产后并发症,值得临床推广应用。

低频脉冲反馈电刺激联合凯格尔运动训练在预防剖宫产术后尿潴留中的应用效果

目的:观察低频脉冲反馈电刺激联合凯格尔运动训练在预防剖宫产术后尿潴留中的应用效果。方法:选取180例剖宫产产妇为研究对象,按照随机数字表法分为对照组和观察组各90例。对照组给予凯格尔运动训练,观察组给予低频脉冲反馈电刺激联合凯格尔运动训练,比较两组术后尿潴留发生率、术后首次排尿时间、残余尿量、盆底肌力正常率首次排尿效果(排尿通畅率、辅助排尿率、排尿困难率)。结果:观察组术后尿潴留发生率为3.33%,明显低于对照组的13.33%,差异有统计学意义(P<0.05);观察组首次排尿时间短于对照组,残余尿量少于对照组,差异均有统计学意义(P<0.05);观察组盆底肌力正常率为95.56%,高于对照组的82.82%,差异有统计学意义(P<0.05);观察组首次排尿通畅率为84.44%,高于对照组的62.22%,辅助排尿率、排尿困难率分别为12.22%、3.33%,低于对照组的25.56%、12.22%,差异有统计学意义(P<0.05)。结论:低频脉冲反馈电刺激联合凯格尔运动训练应用于预防剖宫产术后尿潴留可降低术后尿潴留发生率,减少残余尿量,缩短首次排尿时间,以及提高盆底肌力正常率和首次排尿效果,优于单纯凯格尔运动训练效果。

电刺激生物反馈联合射频治疗盆底功能障碍的应用研究

目的:探讨电刺激生物反馈联合射频治疗盆底功能障碍的临床效果。方法:采用前瞻性随机对照研究,选取2020年6月至2022年6月连云港市妇幼保健院妇科诊治的盆底功能障碍患者144例,采用随机数字表法分电刺激组(48例,电刺激联合生物反馈治疗)、射频组(48例,新型射频技术治疗)、联合组(48例,电刺激联合生物反馈+新型射频技术治疗),评估三组盆底功能障碍、压力性尿失禁、盆底肌筋膜疼痛疗效,比较治疗前及治疗后三组患者盆腔器官脱垂分期(POP-Q)情况,评估生活质量。结果:联合组盆底功能障碍、压力性尿失禁、盆底肌筋膜疼痛总有效率分别为95.83%(46/48)、97.92%(47/48)、93.75%(45/48),均显著高于射频组[79.17%(38/48)、79.17%(38/48)、77.08%(37/48)]、电刺激组[75.00%(36/48)、77.08%(37/48)、72.92%(35/48)],三组差异均有统计学意义(χ^(2)=8.40、9.77、7.66,均P<0.05)。治疗后,联合组POP-Q均显著低于射频组、电刺激组(均P<0.05);联合组盆底功能障碍问卷、尿失禁问卷评分均显著低于射频组、电刺激组(均P<0.05)。结论:电刺激生物反馈联合射频治疗可显著改善盆底功能障碍患者盆底肌力,缓解尿失禁及盆底肌筋膜疼痛症状,提高患者生活质量。