《中国康复理论与实践》

《中国康复理论与实践》 ›› 2012, Vol. 18 ›› Issue (1): 68-70.

• 论文 • 上一篇    下一篇

直肠电刺激缓解脊髓损伤后痉挛的参数优化

远丽1,2，武亮1,3，李建军1,2，徐青1,2   

  1. 1. 首都医科大学康复医学院，北京市 100068；2. 中国康复研究中心北京博爱医院脊柱脊髓神经功能重建科，北京市 100068； 3.北京小汤山医院康复中心，北京市 102211。
  • 收稿日期:2011-03-16 修回日期:2011-08-23 出版日期:2012-01-25 发布日期:2012-01-25
  • 通讯作者: 李建军

Parameter Optimization in Rectal Probe Electrostimulation to Release Spasticity after Spinal Cord Injury

YUAN Li, WU Liang, LI Jian-jun, et al.   

  1. Department of General Surgery, Beijing Charity Hospital, Capital Medical University School of Rehabilitation Medicine,China Rehabilitation Research Centre, Beijing 100068, China
  • Received:2011-03-16 Revised:2011-08-23 Published:2012-01-25 Online:2012-01-25

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摘要： 目的筛选直肠电刺激(RPES)治疗脊髓损伤后痉挛的最佳参数组合。方法应用正交表获得不同的RPES 参数组合。10 例肌张力2 级以上的脊髓损伤患者，每例患者每次接受一种RPES 参数组合治疗，直至完成所有参数组合。每次治疗前后分别评价患者的肌张力、阵挛、反射。采用正交设计方差分析对患者治疗前后差值进行分析。结果刺激强度10 mA、刺激频率3 /min、刺激时间15 min 时对肌张力的缓解最为明显；刺激强度10 mA、刺激频率4 /min、刺激时间10 min 对反射的缓解最明显；刺激强度40 mA、刺激频率2 /min、刺激时间15 min 对阵挛的缓解最明显；刺激强度10 mA、刺激频率2 /min、刺激时间15 min 对综合痉挛指数的缓解最明显。结论刺激强度对肌张力、反射和痉挛指数的影响较大，刺激频率对阵挛的影响较大。缓解单项指标的最佳刺激参数不一定是综合缓解痉挛的最佳刺激参数，应针对患者的不同需要选择参数组合。

关键词: 脊髓损伤, 痉挛, 直肠电刺激, 参数, 痉挛指数

Abstract: Objective To screen the optimal parameters of rectal probe electrostimulation (RPES) to release spasticity after spinal cord injury. Methods 10 patients with muscular tension more than 2 level of the modified Ashworth scale after spinal cord injury received the RPES in 9 parameters combinations from orthogonal array, every patient underwent a combination per day. Their muscular tension, clonus and reflex were recorded before and after each treatment. The varieties were analyzed with orthogonal design variance analysis. Results The optimal parameter for muscular tension was 10 mA, 3 /min, 15 min; for reflex: 10 mA, 4 /min, 10 min; for clonus: 40 mA, 2 /min, 15 min; spasm score: 10 mA, 2 /min, 15 min. Conclusion The stimulus intensity most affects the muscular tension, reflex and spasm score, and the frequency of stimulation most affects the clonus. The parameter components were separately for muscular tension, reflex, clonus and spasm score.

Key words: spinal cord injury, spasticity, rectal probe electrostimualtion, parameter, spasm score