表面肌电图在单侧脑卒中患者30s反复唾液吞咽试验中的比较研究  

A comparative study on 30s repeated swallowing saliva test with surface electromyography in unilateral stroke patients

作　　者：刘邦亮 王根发 朱美兰[1] 江健 张娟娟[1,2] 罗军[1] LIU Bangliang;WANG Genfa;ZHU Meilan(The Second Affiliated Hospital of Nanchang University, Rehabilitation Medicine Division, Nanchang, 33000)

机构地区：[1]南昌大学第二附属医院康复医学科,南昌330006 [2]南昌大学江西医学院 [3]南昌大学第二附属医院中医科

出　　处：《中国康复医学杂志》2018年第7期822-827,共6页Chinese Journal of Rehabilitation Medicine

基　　金：江西省卫计委科技支撑计划(20133059)

摘　　要：目的:通过运用表面肌电图(s EMG)分析单侧脑卒中患者30s反复唾液吞咽试验状态下的肌电信号特征,探讨表面肌电在单侧脑卒中后吞咽障碍的诊断价值。方法:选取单侧脑卒中后吞咽正常患者、单侧脑卒中后吞咽功能障碍患者各15例,分别纳入对照组和试验组,测定两组患者在30s反复唾液吞咽试验状态下健患两侧舌骨上肌群的表面肌电信号,对比分析二者间的异同。结果:在30s反复唾液吞咽试验状态下,同组舌骨上肌群健患两侧波形平均值、峰值、波形面积之间相比较,对照组健患两侧差异均无显著性意义(P>0.05);而试验组健侧以上指标数值均明显大于患侧(P<0.05)。上述指标组间相互比较,试验组健侧略大于对照组健侧,但无明显差异(P>0.05);试验组患侧则明显低于对照组患侧,有明显差异性(P<0.05)。单个吞咽波两组组间吞咽时限相比较,试验组明显大于对照组(P<0.05);30s内吞咽次数相比较,试验组明显少于对照组(P<0.05)。结论:通过对舌骨上肌群表面肌电信号的检测发现,单侧脑卒中后吞咽功能障碍患者健患两侧AEMG、峰值、IEMG值存在明显差异性,而单侧脑卒中后吞咽功能正常患者健患两侧不存在;且两人群中吞咽时间、吞咽次数及患侧单侧AEMG、峰值、IEMG值亦同样有差异,这对运用表面肌电图诊断单侧脑卒中后吞咽功能障碍可能具有积极的临床意义。Objective： To analysis the characteristics of EMG signals in the unilateral stroke patients who take the 30s repeated saliva swallowing test, and discuss the value of surface electromyography which use to evaluate the diagnosis of unilateral stroke. Method： Fifteen patients with swallowing dysfunction after unilateral stroke were allocated into the experimental group and fifteen patients with normal swallowing function after unilateral stroke were allocated into the control group. We analyzed the similarities and differences about the surface EMG signal between the two groups by repeated saliva swallowing test. Result： By the 30s repeated saliva swallowing test,the average waveform, PEAK, and waveform area of the hyoid muscle between the two sides in control group were no significant differences（P〉0.05）. But in the experimental group, the values of the above indicators on the normal side were obviously larger than those on suffered side （P〈0.05）. At the same time, the values of the above indicators on the normal side of the experimental group were slightly larger than the according ones of the control group but not significant（P〉0.05）. However, those values of the diseased side in the experimental group were significantly lower than those in the control group （P〈0.05）. In the experimental group, the time of single swallowing wave was obviously longer than that of the control group（P〈0.05）. Compared to the control group, the frequency of 30s repeated swallowing decreased distinctly in the experimental group （P〈0.05）. Conclusion： The EMG signal on the hyoid muscle showed that AEMG,PEAK,IEMG were significant differences between the two sides of patients in experimental group, but not in the control group. The time, frequency and the AEMG,PEAK,IEMG about the diseased sides were also different between the two groups. That Those findings with surface electromyography will possibly provide us the positive clinical suggestion for the diagnosis of swallowing dysfunction after un

关 键 词：脑卒中 30s反复唾液试验 表面肌电图 吞咽功能障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]