植入性电刺激对失神经骨骼肌影响的研究  

THE STUDY OF THE EFFECT OF IMPLANTABLE ELECTRICAL NERVE STIMULATION ON DENERVATED SKELETAL MUSCLE

作　　者：胡春鹤[1] 朱晓光[1] 张克亮[1] 刘明辉[2] 周晓彬[1] 

机构地区：[1]河北医科大学第三医院手外科,河北石家庄050051 [2]天津人民医院骨科,天津300121

出　　处：《河北医科大学学报》2009年第3期242-245,325,共5页Journal of Hebei Medical University

摘　　要：目的通过建立失神经支配兔小腿三头肌模型,经植入电刺激(implantable electrical nervestimulation,IENS)及经皮电刺激(transcetaneous electrical nerve stnnulation,TENS)后观察小腿三头肌肌电生理变化、肌肉湿质量、肌纤维横截面积、直径及超微结构的变化,研究其减轻失神经肌肉萎缩中的作用,并比较2种刺激方式的疗效。方法新西兰白兔20只随机等分成4组。A 组术后第2天开始 IENS;B 组术后第2天开始 TENS;C组术后4周开始 IENS;D 组不予电刺激。刺激仪均采用 DXZ-1多形波治疗仪。脉冲频率10 ms,脉宽2 ms,电流峰值8～10 mA,频率2～5 Hz。电刺激1次/d,30min/次。术后6周行肌电图检查,并取材送光镜、电镜,免疫组织化学观察。结果 IENS 或 TENS 对失神经骨骼肌湿质量、肌纤维直径及横截面积均有明显影响,A、B 组的肌肉湿质量、肌纤维直径及横截面积高于 C、D 组,差异有统计学意义(P<0.01);但是 C 组肌肉湿质量、肌纤维横截面积与 D组比较无统计学意义(P>0.05)。A 组与 B 组比较肌肉湿质量、肌纤维横截面积亦无统汁学意义(P>0.05)。形态学也有明显改变。骨骼肌失神经电位的改变4组无明显差别。结论骨骼肌失神经后早期进行 IENS可以延缓失神经骨骼肌湿质量、肌纤维直径及横截面积的下降,明显减轻胶原纤维增生。同时 IENS 对骨骼肌失神经纤颤电位的变化无明显影响。Objective A model of rabbit denervated triceps surae muscle atrophy was built to observe the changes after implantable electrical nerve stimulation（IENS） and transcetaneous electrical nerve stimulation （TENS）. The electromyogram, the muscle wet weight, diameter, and / cross section area of myocyte were measured. At the same time the therapeutic effects of the IENS and TENS were compared. Methods Twenty New Zealand rabbits were distributed by weight stochastically to 4 groups. By DXZ-1 tre＇atment machine, IENS was operated to the left crus the 2nd day after operation in Group A TENS was operated the 2nd day after operation in Group B, TENS was operated 4 weeks after operation in Group C,and no electric-stimtilation in Group D. Pulse frequencywas 10ms,pulse extent was 2 ms,the peak groups of organism electric current was 8-10 mA,frequency was 2-5 Hz. The animals were stimulated once a day,30 minutes one time. Electromyogram was clone 6 weeks after operation, then, the material obtained from gastrocnemius was observed under light microscopes and electron microscopes. Results The wet weight,diameter and cross section area of the denervated muscle in Group A and Group B were statistically higher than Group C and Group D. The difference was notable in the statistics（ P〈 0.01）. There were no difference in wet weight and cross section area of mucle between Group C and Group D, and no difference between Group A and Group B. The influence of fibrillation potential of the denervated muscle of the four groups was not notable in the statistics. But the difference was notable in morphology. Conclusion Early lENS after the skeletal muscle denervated can delay muscular atrophy and hyperplasia of collagen fiber and can ameliorate the decline of the wet weight,muscle fiber diameter and cross sector. However IENS can＇t affect the fibrillation potential of the denervated muscle.

关 键 词：电刺激疗法 肌萎缩 兔 

分 类 号：R746.4[医药卫生—神经病学与精神病学]