吞咽表面肌电图评估扁桃体切除术后患者疼痛程度的可能性研究

目的 探讨吞咽表面肌电图用于评估扁桃体切除术后患者疼痛程度的可能性.方法 选取行扁桃体切除术的患者32例,分别于术前、术后1 d和术后2 d行吞咽的表面肌电图检查.同时对所有患者术后行吞咽疼痛的视觉模拟评分,连续2 d, 1次/d.结果 所有的吞咽方式中,术后1 d和术后2 d干咽时间和振幅皆 < 术前,吞咽20 mL水所需时间 > 术前,而振幅 < 术前.术后1 d与术后2 d的干咽时间、干咽振幅、20 mL水吞咽时间、20 mL吞咽振幅和视觉模拟评分法(VAS)都没有明显差别.术后表面肌电图振幅变化、时间变化程度与VAS评分无明显相关性(P>0.05).结论 吞咽表面肌电图能够观察到扁桃体切除术后患者因疼痛导致的吞咽时的肌肉活动变化,今后有可能根据这些变化来指导是否需要镇痛药物,但其不能用于判定疼痛的程度.

Pain evaluation with surface electromyogram in patients after tonsillectomy

Objective To study the method to evaluate the degree of pain in the patients after tonsillectomy with surface EMG. Methods Thirty two patients (15 men, 17 women; aged from 20 to 60 years) who underwent tonsillectomy in our hospital were included in this study. Swallowing surface electromyogram (sEMG) was examined before the operation, and the first and second day after the operation. Meantime, the degree of pain was evaluated using the visual analogue scale (VAS) on the first and second day after the operation. Results In all swallow styles, the duration and amplitudes of sEMG of dry swallow after the operation were shorter and less than those before the operation. The durations of sEMG o of 20 mL water swallow after the operation were longer than those the before operation, while the amplitudes were less. There were no significant differences in VAS, duration and amplitudes of sEMG in dry swallow, 20 mL water swallow between the two days after the operation. The change of duration and amplitudes of sEMG after the operation showed no correlation with the VAS score (P>0.05). Conclusion sEMG can reflect the changes of the muscular activity during swallowing after tonsillectomy because of pain. The changes of sEMG may be used as an indicator for analgesics in the future, but it cannot be used to evaluate the degree of the pain after tonsillectomy.