增强型体外反搏对缺血性脑卒中患者运动功能的影响

关键词：增强型体外反搏  缺血性脑卒中  运动诱发电位  表面肌电图

Keywords:enhanced external counterpulsation  ischemic stroke  motor evoked potential  surface electromyography

摘要：

      摘要 目的：观察增强型体外反搏（enhanced external counter pulsation， EECP）对缺血性脑卒中患者运动功能的影响。 方法：选取缺血性脑卒中患者60例，按1∶1比例将患者分为试验组（EECP组）和对照组（伪EECP组）。试验组采用常规偏瘫康复训练加增强型体外反搏治疗。对照组采用与试验组相同的常规偏瘫康复训练方案加伪EECP治疗。两组治疗前、治疗结束后观察如下指标：简化Fugl-Meyer运动功能量表（Fugl-Meyer assessment， FMA）、Berg量表（Berg Balance Scale， BBS）、Barthel指数（Barthel Index， BI），同时行运动诱发电位（motor evoked potential， MEP）、中枢传导时间（central conduction time， CMCT）以及患侧踝关节最大背屈时胫前肌等长收缩时肌电积分（integral electromyographic， iEMG）水平检测。 结果：治疗后，治疗组下肢FMA差值、MEP潜伏期差值、CMCT差值、下肢胫前肌单位时间iEMG及其差值较对照组显著性增加（P<0.05）。 结论：增强型体外反搏治疗结合常规康复治疗可显著改善恢复期缺血性脑卒中患者患侧下肢运动功能。

Abstract:

      Abstract Objective：To observe the effect of enhanced external counter pulsation on motor function in patients with ischemic stroke. Method：Sixty patients with ischemic stroke were selected and divided into experimental group （EECP group） and control group （sham EECP group） with a ratio of 1∶1. The experimental group was treated with conventional hemiplegia rehabilitation training and enhanced external counterpulsation. The control group was treated with the same conventional hemiplegia rehabilitation training program and sham EECP. The following outcomes were observed before and after treatment in the two groups： simplified Fugl-Meyer assessment（FMA）， Berg Balance Scale （BBS）， Barthel Index （BI）. Motor evoked potential （MEP）， central conduction time （CMCT）， and integral electromyographic （iEMG） of tibialis anterior muscle during isometric contraction during maximum dorsiflexion of the affected ankle were also examined. Result：After treatment， the FMA difference， MEP latency difference， CMCT difference， unit time iEMG and its difference of lower limb anterior tibial muscle in the treatment group were significantly higher than those in the control group （P<0.05）. Conclusion：Enhanced external counter pulsation therapy combined with conventional rehabilitation therapy can significantly improve the motor function of the affected side of the lower limb of patients with ischemic stroke in the recovery period， and there is no obvious adverse reaction.