经皮神经肌肉电刺激促进周围神经再生的应用价值

背景周围神经损伤后的变性与再生是一个很复杂的病理生理过程,关于电刺激对神经再生恢复的促进作用仍需要探讨.目的比较经皮神经肌肉电刺激治疗促进不同部位周围神经再生的作用与效果.设计以患者为观察对象,病例分析.单位一所医学院附属医院的神经电理室和骨科.对象1999-10/2003-06宁夏医学院附属医院骨科、神经内科门诊及住院的周围神经损伤患者中,选择经临床诊断和肌电图证实的78例周围神经不全损伤患者.方法对入选78例周围神经不全损伤患者采用丹迪Cantata型肌电图仪对,进行经皮神经肌肉电刺激治疗,观察受损周围神经功能恢复情况,并行治疗前、后肌电图对比分析及不同病程治疗后的疗效对比分析.主要观察指标①治疗前后肌电图变化.②神经传导速度变化.③神经功能恢复情况.结果78例臂丛神经、坐骨神经不全损伤者,经1～10个疗程的治疗,53例患者肢体运动、感觉功能恢复正常,18例患者肢体运动、感觉功能明显改善,有效率91%(71/78).治疗后失神经电位,运动神经传导速度,感觉神经传导速度均较治疗前有明显改善.结论经皮神经肌肉电刺激治疗,可促进周围神经的再生,改善受损神经局部血液循环,提高神经肌肉的兴奋性.

Applicative value of percutaneous nerve-muscle electric stimulation in the promotion of peripheral neuranagenesis

BACKGROUND: Degeneration and regeneration after peripheral nerve injury is a very complex pathophysiological process. It still needs to investigate the promotive effects of electric stimulation in neuranagenesis.OBJECTIVE: To compare the effect and result of percutaneous nerve-muscle electric stimulation therapy in peripheral neuranagenesis of different position.DESIGN: A case analysis based on patients.SETTING: Laboratory of neuroelectrophysiology and department of orthopedics of a medical university affiliated hospital.PARTICIPANTS: Totally 78 patients with peripheral neurologic impairment proved by clinical diagnosis and electromyogram(EMG) were selected from the patients with peripheral nerve injury visited or hospitalized by the Department of Neurology and Orthopedics, Affiliated Hospital of Ningxia Medical University between October 1999 and June 2003.METHODS: Cantana EMG was used. Totally 78 cases received percutaneous nerve-muscle electric stimulation (PNMES) therapy for the observation of the restoration of peripheral nerve function. Therapeutic effectiveness of different course of disease was compared and analyzed by comparing and analyzing the EMG before and after therapy.RESULTS: In 78 patients with brachiplex nerve and sci atic nerve impairment, 53 cases had completely restored motor and sensory functions, 18 cases had significantly improved motor and sensory functions with the effective rate of 91% (71/78) after 1 to 10 courses of therapy. Post-therapeutic denervated potential, motor nerve conduction velocity(MNCV) and sensory nerve conduction velocity(SNCV) were significantly improved compared with that of before therapy.CONCLUSION: PNMES therapy can promote peripheral neuranagenesis,improve the local blood circulation of the impaired nerve and elevate the excitability of nerve and muscle.