| Objective: Treat the patients of skeletal muscle atrophy after peripheral nerve injury through electrical stimulation. Follow up the patients, including the EMG results and the clinical specialized examination of sensory recovery and muscle force recovery before and after treatment. Analyze the statistical results to evaluate the therapeutic effect. Observe the clinical effects on the recovery of earlier electrical stimulation of skeletal muscle atrophy to provide an effective way to the prevention and treatment of the skeletal muscle atrophy, improve the clinical treatment effect furtherly, and reduce the loss of skeletal muscle function.Methods: Select 60 cases of patients with peripheral nerve injury in extremitas superior from April,2007 to October,2008 in our hospital. 30 patients were randomized to receive neuromuscular electrical stimulation treatment, another 30 patients were received neurotrophic drugs and exercise therapy.Neuromuscular electrical stimulation treatment of 30 patients, including the radial nerve injury (14), the median nerve injury(10), the ulnar nerve injury(6). All cases were injured after 6 hours-3 months and received hospital operation, 10cases were joined by releasing anastomosis,15 cases were joined directly by anastomosis, 5 cases were joined by nerve transplantation anastomosis. Three days after operation, all 30 patients were treated with electrical stimulation through NDI500. Suitable frequency for stimulating: 2~5Hz.; Stimulating parts: a distance of 3~5cm from the wound; Stimulating strength: 20~30mA; Stimulating time: 5min per every part, undertook 3 course of electrical stimulation treatment, the first course:2times/d,Interval 2d, lasted for one month; the second and third course: 1times/d, Interval 2d, lasted for two months, assisted the patients to train with active and passive muscle contraction.Another 30 patients were treated with neurotrophic drugs and sports therapy, including the radial nerve injury(11), the median nerve injury(13), the ulnar nerve injury(6). All cases were injured after 6 hours-3 months and received hospital operation, 12cases were joined by releasing anastomosis,14 cases were joined directly by anastomosis, 4 cases were joined by nerve transplantation anastomosis. Drug therapy: vitamin B1, vitamin B6, po,10mg each, three times a day; Mecobalamin, im, 500μg, every other day, for one month. Exercise therapy: train the upper , lower limbs and hand function according to different muscle force.Two groups were received EMG and specialized examination before and after treatment, follow-up rate was 100%, last for six months. Observe EMG results before and after treatment, the improvement of sensory recovery and muscle force recovery after electrical stimulation therapy. Assess the therapeutic effect according to the clinical curative effect evaluation standards and statistical significance.Results:(1) The ECG results comparison of electrical stimulation treatment group and control group: The cases of denervated potential number were significantly reduced, while the new potential, regenerative potential, motor unit potential, SCV and MCV number were obviously increased. The cases of recruitment combination potential were appeared more. The improvement of ECG examination in electrical stimulation treatment group is of clinic value when the statistical constituent ratio (P < 0.001) is significant.(2) The condition of sensory recovery comparison of electrical stimulation treatment group and control group after treatment: The statistical constituent ratio (P<0.05) is significant. The recovery rate in electrical stimulation treatment group and control group is 70% and 40% respectively. The improvement in the former group is more conspicuous. The statistical recovery rate (P=0.020<0.05) is significant.(3) The condition of muscle force recovery comparison of electrical stimulation treatment group and control group after treatment: The statistical constituent ratio (P<0.05) is significant. The recovery rate in electrical stimulation treatment group and control group is 80% and 50.0% respectively. The improvement in the former group is more conspicuous. The statistical recovery rate (P=0.028<0.05) is significant.(4) The therapeutic effect of fineness rate comparison of electrical stimulation treatment group and control group after treatment: The statistical constituent ratio (P<0.05) is significant. The fineness rate in electrical stimulation treatment group and control group is 83.3% and 43.3% respectively. The improvement in the former group is more conspicuous.Conclusion: Early postoperative neuromuscular electrical stimulation treatment of skeletal muscle atrophy after peripheral nerve injury, can promote the recovery of injured nerve function, prevent atrophy of the denervated muscle, enhance the curative rate and reduce the mutilation rate. Clinical practice has been proved that electrical stimulation treatment is more effective, than pure with drug and exercise therapy. It provides an effective way to treat skeletal muscle atrophy of peripheral nerve injury. |
PDF Full Text Request