He Jinhua,Liu Hua,Qin Rong,et al.Efficacy of myoelectric biofeedback therapy on neonatal parturient brachial plexus injury[J].Journal of Clinical Pediatric Surgery,2019,18(05):413-418.[doi:10.3969/j.issn.1671-6353.2019.05.015]
肌电生物反馈疗法对新生儿分娩性臂丛神经损伤的疗效分析
- Title:
- Efficacy of myoelectric biofeedback therapy on neonatal parturient brachial plexus injury
- Keywords:
- Birth Injuries; Brachial Plexus Neuropathies/RH; MyoelectricBiofeedback; Electromyography; Treatment Outcome; Infant; Newborn
- 分类号:
- R722.19;R493
- 摘要:
- 目的 初步评价肌电生物反馈疗法对新生儿分娩性臂丛神经损伤的临床疗效。方法 对湖南省儿童医院162例新生儿分娩性臂丛神经损伤患儿的临床资料进行回顾性分析，按照患儿家长是否接受并全程配合肌电生物反馈治疗将受试者分为观察组及对照组；对照组采用运动疗法、早期手功能训练及针刺等进行综合康复治疗，观察组在对照组基础上添加肌电生物反馈治疗，一个疗程（3个月）结束后针对两组患儿各项临床症状评分（评分越高代表相应临床表现越明显）及神经肌电图CMAP变化情况进行对比。结果 两组接受治疗后临床症状评分均较治疗前显著降低（P<0.05）；从治疗后评分来看，观察组临床症状评分显著低于对照组（P<0.05），观察组中上干型及下干型临床症状评分明显低于对照组（P<0.05），而两组全干型临床症状评分无明显差异（P>0.05）。观察组临床疗效总有效率及肌电图CMAP变化率高于对照组（P<0.05），观察组全干型临床有效率及肌电图CMAP恢复有效率均高于对照组（P<0.05），两组上干型及下干型则无明显差异（P>0.05）。结论 肌电生物反馈疗法治疗新生儿分娩性臂丛神经损伤效果总体满意，值得临床积极推广。
- Abstract:
- Objective To explore the clinical efficacy of myoelectric biofeedback therapy on neonatal parturient brachial plexus injury. Methods Retrospective analysis was performed for 162 neonates with parturient brachial plexus injury.They were divided into treatment and control groups according to whether or not their parents approved and cooperated in myoelectric biofeedback therapy.The control group received such comprehensive rehabilitations as exercise therapy,early hand function training and acupuncture,etc.The clinical symptom scores were compared between two groups before and after 3-month treatment.And the clinical efficacy and neuromyographic recovery of two groups were compared. Results The clinical symptom scores of two groups were significantly lower after treatment than before (P<0.05).The clinical symptom score of treatment group was significantly lower than that of control group (P<0.05).The clinical symptom scores of upper/lower trunk type were significantly lower in treatment group than those in control group (P<0.05).However,no significant inter-group difference existed in clinical symptom score of whole trunk type (P>0.05).The clinical effective rate and neuromyographic compound muscle action potential (CMAP) recovery rate were higher in treatment group than those in control group (P<0.05).The clinical and electromyographic CMAP recovery efficiencies of treatment group were higher than those of control group (P<0.05).However,no significant difference existed between upper and lower trunk types (P>0.05).Conclusion Myoelectric biofeedback therapy was such an effective treatment for neonatal parturient brachial plexus injury that it was worthy of wider popularization.
参考文献/References:
1 陈亮,顾玉东.分娩性臂丛神经麻痹的诊治[J].中华小儿外科杂志,2004,25(5):460-462.DOI:10.3760/cma.j.issn.0253-3006.2004.05.024.Chen L,Gu YD.Diagnosis and treatment of parturient brachial plexus palsy[J].Chin J Pediatr Surg,2004,25(5):460-462.DOI:10.3760/cma.j.issn.0253-3006.2004.05.024.
2 Hudic I,Fatusic Z,Sinanovic O,et al.Intrapartum risk factors for brachial plexus palsy[J].MedArh,2007,61(1):43-46.
3 Russo SA,Kozin SH,Zlotolow DA,et al.Scapulothoracic and glenohumeral contributions to motion in children with brachial plexus birth palsy[J].J Shoulder Elbow Surg,2014,23(3):327-338.DOI:10.1016/j.jse.2013.06.023.
4 贠国俊,曹建国,吴凌云,等.综合康复治疗50例分娩性臂丛损伤的分析[J].首都医药,2014,6(12):17-18.Yun GJ,Chao JG,Wu LY.Analysis of 50 cases of parturient brachial plexus injury treated by comprehensive rehabilitation[J].Capital Medicine,2014,6(12):17-18.
5 刘敏,李蒿,刘春辉,等.肌电生物反馈和运动疗法治疗桡神经损伤的效果[J].中国康复理论与实践,2013,19(2):167-169.DOI:10.3969/j.issn.1006-9771.2013.02.019.Liu M,Li K,Liu CH,et al.Effect of myoelectric biofeedback and motor therapy on radial nerve injury[J].Chin J Rehabil Theory Prac,2013,19(2):167-169.DOI:10.3969/j.issn.1006-9771.2013.02.019.
6 Liu J,Pho R W,Kour A K,et al.Neurologic deficit and recovery in the donor limb following cross-C7 transfer in brachial-plexus injury[J].Journal of Reconstructive Microsurgery,1997,13(04):237-242.DOI:10.1055/s-2007-1000230.
7 顾玉东.臂丛神经损伤的分型及手术方案[J].中华卫生应急电子杂志,2016,2(2):74-76.DOI:10.3877/cma.j.issn.2095-9133.2016.02.002.Gu YD.Classification and surgical procedure of brachial plexus injury[J].Chin J Hygiene Rescue(Electronic Edition),2016,2(2):74-76.DOI:10.3877/cma.j.issn.2095-9133.2016.02.002.[JB({]
8 Smith AB,Gupta N,Strober J,et al.Magnetic resonance neurography in children with birth-related brachial plexus injury[J].Pediatric Radiology,2008,38(2):159-163.DOI:10.1007/s00247-007-0665-0.
9 陈炜炜,丁江浩,杨卫远.肌电生物反馈治疗小儿分娩性臂丛神经损伤[J].包头医学院学报,2016,32(11):50-52.Chen WW,Ding JH,Yang WY.Treatment of brachial plexus injury in children with emg biofeedback[J].Journal of Baotou Medical College,2016,32(11):50-52.
10 Elhassan B,Bishop A,Shin A,et al.Shoulder Tendon Transfer Options for Adult Patients With Brachial Plexus Injury[J].J Hand Surg Am,2010,35(7):1211-1219.DOI:10.1016/j.jhsa.2010.05.001.
11 黄凤舞,张玲,胡晔,等.综合康复治疗对小儿臂丛神经损伤疗效分析[J].医学信息,2011,24(23):614.Huang FW,Zhang L,Hu Y,et al.Effect analysis of comprehensive rehabilitation treatment on brachial plexus injury in children[J].Medical Information,2011,24(23):614.
12 黄利娟.臂丛神经损伤的康复治疗效果观察与分析[J].按摩与康复医学,2011,2(12):57-58.DOI:10.3969/j.issn.1008-1879.2011.12.036.Huang LJ.Observation and analysis of the rehabilitation effect of brachial plexus injury[J],Chinese Manipulation &Rehabilitaion Medicine.2011,2(12):57-58.DOI:10.3969/j.issn.1008-1879.2011.12.036.
13 朱敏杰,耿香菊.肌电生物反馈疗法对痉挛型脑性瘫痪儿童康复效果的影响[J].临床心身疾病杂志,2017,23(2):23-25.DOI:10.3969/j.issn.1672-187x.2017.02.008-0023-03. Zhu MJ,Geng XJ.Effects of EMGBFT on rehabilitation outcome of children withspastic cerebral palsy[J].J Clin Psychosom Dis,2017,23(2):23-25.DOI:10.3969/j.issn.1672-187x.2017.02.008-0023-03.
14 邓晓青,滕新,古丽梅,等.肌电生物反馈疗法在肌张力低下脑瘫患儿康复治疗中的应用[J].临床合理用药,2016,9(19):164-165.DOI:10.15887/j.cnki.13-1389/r.2016.19.098.Deng XQ,Teng X,Gu LM,et al.Application of myoelectric biofeedback therapy in rehabilitation of children with hypotonic cerebral palsy[J].Chin J of Clinical Rational Drug Use,2016,9(19):164-165.DOI:10.15887/j.cnki.13-1389/r.2016.19.098.
15 文怡川,刘万平,陈小虎.肌电生物反馈刺激改善缺血性卒中患者急性期上肢功能的疗效观察[J].检验医学与临床,2018,15(10):1384-1386.DOI:10.3969/j.issn.1672-9455.2018.10.003.Wen YC,Liu FP,Chen XH.The effect of myoelectric biofeedback stimulation on the improvement of acute phase upper limb function in patients with ischemic stroke[J].Lab Med Clin,2018,15(10):1384-1386.DOI:10.3969/j.issn.1672-9455.2018.10.003.
16 张明,李坤彬,许梦雅.早期综合康复配合肌电生物反馈治疗急性脑卒中的疗效观察[J].中国实用神经疾病杂志,2016,19(22):54-56. Zhang M,Li KB,Xu MY.Effect observation of early comprehensive rehabilitation combined with myoelectric biofeedback in the treatment of acute stroke[J].Chinese Journal of Practical Nervous Diseases N,2016,19(22):54-56.
17 何园园,许林海,杨晶晶.运动疗法结合肌电生物反馈训练对ICU不完全性颈髓损伤患者功能恢复的影响[J].浙江医学,2016,38(23):1915-1918,1923. He YY,Xu LH,Yang JJ.Exercise combined with electromyographic biofeedback for functional recovery after incomplete cervical spinal cord injury in ICU[J].Zhejiang Medical,2016,38(23):1915-1918,1923.
18 张会春,娄普,耿香菊.肌电生物反馈疗法在重症手足口病患儿康复中的对照研究[J].中国实用神经疾病杂志,2017,20(14):19-21.DOI:10.3969/j.issn.1673-5110.2017.14.006.Zhang HC,Lou P,Geng XJ.Controlled study of electromyographic biofeedbackin rehabilitation of severehand-foot-mouthdisease.Chinese Journal of Practical NervousDiseases,2017,20(14):19-21.DOI:10.3969/j.issn.1673-5110.2017.14.006.
19 马彩云,尚清,张继华,等.肌电生物反馈治疗婴儿臂丛神经损伤的疗效[J].实用儿科临床杂志,2010,25(16):1282-1283.Ma CY,Shang Q,Zhang JH,et al.Effect of myoelectric biofeedback on brachial plexus injury in infants[J].J Appl Clin Pediatr,2010,25(16):1282-1283.
20 朱俞岚,张备,陈亮,等.肌电反馈体感游戏治疗分娩性臂丛神经麻痹儿童上肢功能的效果[J].中国康复理论与实践,2016,22(12):1446-1450.DOI:10.3969/j.issn.1006-9771.2016.12.018.Zhu YL,Zhang B,Chen L,et al.Effect of electromyographic feedback somatosensory games on upper limb function in children with parturient brachial plexus palsy[J].Chin J Rehabil Theory Prac,2016,22(12):1446-1450.DOI:10.3969/j.issn.1006-9771.2016.12.018.
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备注/Memo
收稿日期:2018-12-18。
通讯作者:何金华,Email:hejinhua110@sina.com