肌电图仪经皮神经肌肉定位定量电刺激对腓总神经损伤的疗效分析

逯霞　艾克拜尔·哈里克　许健

[摘要] 目的 評估肌电图仪经皮神经肌肉定位定量电刺激对腓总神经损伤患者的临床疗效及安全性。 方法 选取2015年1月～2016年12月新疆医科大学第二附属医院诊断为腓总神经部分损伤的患者68例，根据随机数字表方法分为两组。对照组23例，常规治疗，未接受肌电图仪电刺激；短程组24例，予以电刺激治疗，疗程为2周；长程组21例，予以电刺激治疗，疗程为1个月。分别于治疗前、治疗3个月后比较三组患者临床疗效及感觉和运动功能改善情况，同时比较三组的神经传导速度（NCV）、趾短伸肌复合肌肉动作电位（CMAP）波幅及运动电位潜伏期（MEPLP）等腓总神经肌电生理数据。随访1个月比较三组的不良反应发生率。 结果 三组的总有效率长程组>短程组>对照组（P < 0.05）。三组的感觉和运动功能优良率长程组>短程组>对照组（P < 0.05）。治疗后三组的NCV、CMAP均较治疗前增加（P < 0.05），且长程组>短程组>对照组（P < 0.05）；治疗后三组的MEPLP均较治疗前减短（P < 0.05），且长程组<短程组<对照组（P < 0.05）。三组患者治疗及随访期间均未发生严重不良反应。 结论 应用肌电图仪经皮神经肌肉定位定量电刺激能有效改善腓总神经损伤的恢复，长疗程患者恢复程度更佳且安全性好。

[关键词] 腓总神经损伤；肌电图；经皮神经肌肉电刺激；临床疗效

[中图分类号] R745 [文献标识码] A [文章编号] 1673-7210（2017）07（a）-0051-04

[Abstract] Objective To evaluate the clinical effect and safety of transcutaneous electrical stimulation treatment （TEST） on common peroneal nerve （CPN） injury with EMG instrument. Methods From January 2015 to December 2016， in the Second Affiliated Hospital， Xinjiang Medical University， 74 patients diagnosed CPN injury were collected and divided into three groups by random number table， control group （23 cases， received normal therapy without TEST by EMG instrument）， short-term group （24 cases， received TEST by EMG instrument for 2 weeks） and long-term group （21 cases， received TEST by EMG instrument for 1 month）. The indexes of clinical effect and the degrees of movement and perception improvement， the indexes of nerve conduction velocity （NCV）， compound muscle action potential （CMAP） amplitude of extensor brevis digitorum and motor evoked potentials latent period （MEPLP）， were compared among three groups at pre-therapy and 3-month post-therapy. Follow-up 1 month， the occurrences of adverse reaction were compared. Results The total effective rates of three groups were long-term group > short-term group > control group （P < 0.05）. The excellent rates of three groups were long-term group > short-term group > control group （P < 0.05）. The NCV and CMAP of three groups at 3-month post-therapy were higher than at pre-therapy （P < 0.05）， and long-term group > short-term group > control group （P < 0.05）. The MEPLP of three groups at 3-month post-therapy were lower than at pre-therapy （P < 0.05）， and long-term group < short-term group < control group （P < 0.05）. During treatment and follow-up 1 month， there were no serious adverse effect. Conclusion The TEST with EMG instrument can efficiently improve the clinical effect of CPN injury and the clinical effect of long-term TEST is better and the safe.

[Key words] Common peroneal nerve； EMG； Transcutaneous electrical stimulation treatment； Clinical effect

腓总神经是下肢重要的周围神经之一，因外伤、骨折等原因导致的腓总神经部分损伤已成为发病率较高的疾病，临床表现主要为患者下肢运动及感觉功能障碍，患肢肌肉萎缩，若不及时治疗，预后不佳会严重影响患患者的生活质量[1]。目前腓总神经部分损伤尽管充分予以治疗，然而患肢运动及感觉功能恢复程度一直难以令人满意，因此也成为困扰临床医生的难题[2]。近年来实验动物研究证实，早期规律神经电刺激能改善受损神经局部微循环、促进受损神经功能恢复、提高神经肌肉的兴奋性以及有效改善骨骼肌失神经萎缩的发生，因此研究者提出对于腓总神经部分损伤患肢接受定位定量电刺激能有效改善患肢的临床疗效[3]。然而神经……