重复外周磁刺激对左右颈7神经交叉移位术后脑卒中患者上肢运动功能的效果

doi:10.3969/j.issn.1006-9771.2023.06.008

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (6): 686-690.doi: 10.3969/j.issn.1006-9771.2023.06.008

重复外周磁刺激对左右颈7神经交叉移位术后脑卒中患者上肢运动功能的效果

许苗苗^1a, 李楠^1b, 应颖^1a, 杨凯翔², 杨婧瑞^1a, 李杰^1a, 邱彦群^1a^,²()

1.上海市静安区中心医院/复旦大学附属华山医院静安分院，a.手及上肢外科；b.老年中心，上海市 200040
2.复旦大学附属华山医院手外科，上海市 200040

收稿日期:2022-09-13 修回日期:2023-05-29 出版日期:2023-06-25 发布日期:2023-07-14
通讯作者: 邱彦群(1984-)，男，汉族，博士，副主任医师，主要研究方向：中枢瘫后功能重建，左右颈7神经交叉移位术。E-mail： yanqunqiu@fudan.edu.cn
作者简介:许苗苗(1991-)，女，汉族，河北沧州市人，硕士，主治医师，主要研究方向：手及上肢功能障碍康复。
基金资助:
上海市静安区卫生科研课题(2019QN01)

Effect of repetitive peripheral magnetic stimulation on upper limb motor function of stroke patients after contralateral seventh cervical nerve transfer

XU Miaomiao^1a, LI Nan^1b, YING Ying^1a, YANG Kaixiang², YANG Jingrui^1a, LI Jie^1a, QIU Yanqun^1a^,²()

1. a. Department of Hand and Upper Limb Surgery; b. Department of Senior Center, Jing'an District Centre Hospital of Shanghai/Jing'an Branch of Huashan Hospital, Fudan University, Shanghai 200040, China
2. Department of Hand and Upper Limb Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China

Received:2022-09-13 Revised:2023-05-29 Published:2023-06-25 Online:2023-07-14
Contact: QIU Yanqun, E-mail: yanqunqiu@fudan.edu.cn
Supported by:
Shanghai Jing'an District Health Scientific Research Project(2019QN01)

摘要/Abstract

摘要：

目的观察重复外周磁刺激对脑卒中左右颈7神经交叉移位术后患者上肢运动功能康复的疗效。
方法 2020年5月至2022年5月，上海市静安区中心医院脑卒中左右颈7神经交叉移位术后康复患者34例，随机分为对照组(n = 17)和观察组(n = 17)。两组均接受药物治疗和康复训练。观察组在此基础上给予患侧肢体重复外周磁刺激，对照组给予伪刺激，共8周。治疗前后采用Fugl-Meyer评定量表上肢部分(FMA-UE)和华山量表进行肢体功能评价。
结果每组各失访2例。观察组男性较多(χ² = 6.136, P < 0.05)。治疗后，两组FMA-UE和华山量表评分均明显改善(t > 4.000, P < 0.01)，观察组治疗前后FMA-UE和华山量表评分差值均大于对照组(t > 2.362, P < 0.05)。
结论重复外周磁刺激可以改善脑卒中左右颈7神经交叉移位术后患者上肢运动功能。

关键词: 脑卒中, 左右颈7神经交叉移位术, 重复外周磁刺激, 上肢, 运动功能

Abstract:

Objective To explore the effect of repetitive peripheral magnetic stimulation on upper limb motor function rehabilitation of stroke patients after contralateral seventh cervical nerve transfer (CC7).
Methods From May, 2020, to May, 2022, 34 stroke patients with hemiplegia underwent CC7 in Jing'an District Centre Hospital of Shanghai were randomly divided into control group (n = 17) and observation group (n = 17). Both groups received conventional rehabilitation. The observation group accepted repetitive peripheral magnetic stimulation, and the control group received sham stimulation, for eight weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Hua-Shan Grading of Upper Extremity (H-S grading) before and after treatment.
Results Two cases dropped down in each group. There was difference in gender between two groups (χ² = 6.136, P < 0.05). After treatment, the scores of FMA-UE and H-S grading significantly improved in both groups (t > 4.000, P < 0.01), and the improvement was better in the observation group than in the control group (t > 2.362, P < 0.05).
Conclusion Repetitive peripheral magnetic stimulation could improve the motor function of upper limb and hand of stroke patients with hemiplegia after CC7.

Key words: stroke, contralateral seventh cervical nerve transfer, repetitive peripheral magnetic stimulation, upper limb, motor function

中图分类号:

R743.3

许苗苗, 李楠, 应颖, 杨凯翔, 杨婧瑞, 李杰, 邱彦群. 重复外周磁刺激对左右颈7神经交叉移位术后脑卒中患者上肢运动功能的效果[J]. 《中国康复理论与实践》, 2023, 29(6): 686-690.

XU Miaomiao, LI Nan, YING Ying, YANG Kaixiang, YANG Jingrui, LI Jie, QIU Yanqun. Effect of repetitive peripheral magnetic stimulation on upper limb motor function of stroke patients after contralateral seventh cervical nerve transfer[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(6): 686-690.

图/表 3

参考文献 23

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组别	n	性别(男/女)/n	年龄/岁	病程/年	偏瘫侧(左/右)/n	卒中类型(梗死/出血)/n
对照组	15	10/5	48±14.34	4.033±3.221	10/5	11/4
观察组	15	13/2	46±13.26	3.767±3.017	9/6	9/6
χ²/t值		6.136	1.190	0.436	3.394	0.144
P值		0.013	0.244	0.670	0.065	0.705

组别	n	治疗前	治疗后	差值	t值	P值
对照组	15	31.47±11.98	36.27±12.64	4.800±3.448	5.392	< 0.001
观察组	15	28.53±9.826	36.87±10.39	8.333±4.655	6.934	< 0.001
t值		0.733	0.142	2.362
P值		0.469	0.888	0.025

组别	n	治疗前	治疗后	差值	t值	P值
对照组	15	2.667±1.113	3.200±1.207	0.533±0.516	4.000	0.001
观察组	15	2.067±0.961	3.533±1.302	1.467±0.640	8.876	< 0.001
t值		1.580	0.727	4.396
P值		0.125	0.473	0.001

重复外周磁刺激对左右颈7神经交叉移位术后脑卒中患者上肢运动功能的效果

Effect of repetitive peripheral magnetic stimulation on upper limb motor function of stroke patients after contralateral seventh cervical nerve transfer

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