经皮激光气化减压术对腰椎间盘突出症患者椎旁肌电活动规律的影响作用研究  

Study on the Effect of Percutaneous Lasers Disk Deoompression for the Paraspinal Electromyographic Regularity in Patients with Lumbar Disc Herniation

作　　者：赵继荣[1] 赵宁[1] 王兴盛[2] 马同 张海清[1] 薛旭 Zhao Jirong;Zhao Ning;Wang Xingsheng;Ma Tong;Zhang Haiqing;Xue Xu(Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou,Gansu 730050,China;Gansu Institute of Traditional Chinese Medicine,Lanzho,Gansu 730050,China)

机构地区：[1]甘肃省中医院脊柱骨科,甘肃兰州730050 [2]甘肃省中医药研究院,甘肃兰州730050

出　　处：《应用激光》2021年第1期206-210,共5页Applied Laser

基　　金：国家自然科学基金(81760877);兰州市创新人才项目(2018-RC-99);甘肃省自然科学基金(17JR5RA054)。

摘　　要：目的:观察分析对经皮激光气化减压术(percutaneous lasers disk deoom pression, PLDD)治疗腰椎间盘突出症(lumbar disc herniation, LDH)患者术后表面肌电图监测数据变化情况,探究躯干肌电活动规律与PLDD疗效的相关性。方法:对2015年3月至2016年4月对36例在甘肃省中医院接受PLDD治疗的LDH患者进行术中、术后表面肌电(surface electromygraphy, sEMG)及表面肌电生物反馈(surfaceelectromygraphic biofeedback, sEMGBF)监测。受试患者分别采用长收缩状态、运动状态、静态体位状态下进行椎旁肌群sEMG监测,测试椎旁肌肉群患侧与健侧的中位频率斜率(MF slope, MFs)、曲伸直比(FER)以及平均肌电图波幅,整理测试数据进行统计分析。结果:PLDD术后1月、3月及6月时,术后患侧MFs的衰减降低,与治疗前比较差异显著(P<0.05),健侧MFs的衰减无显著改变;PLDD术后平均EMG波幅健侧无显著改变,患侧波幅有增高趋势,但差异无显著性。患侧FER=0.46±0.13,与治疗前FER=0.89±0.19;比较差异具有显著性(P<0.05),健侧FER的衰减无显著改变。结论:经皮激光汽化减压术治疗腰椎间盘突出症可明显改善椎旁肌肉疲劳、活动失调、平衡失调等病理性状态,有效恢复椎旁肌肉的强度、平衡性和协调性;LDH治疗后的sEMG监测临床疗效的评价和疾病预后的判断具有积极的临床意义。Objective: to observe and analyze the changes of surface electromyography monitoring data after Percutaneous Lasers Disk DeoomPression(PLDD) treatment of Lumbar disc herniation(LDH) and investigate the correlation between the electromyographic regularity of trunk and the therapeutic efficacy of PLDD. Method: select from Mar. 2015 to Apr. 2016 in 36 cases of LDH patients treated with PLDD in Gansu Provincial Hospital of TCM, and to monitor those patients in the period of intraoperation, postoperative surface electromyography(sEMG) and surface electromyographic biofeedback. The subjects underwent the sEMG monitoring of paraspinal muscles using long contraction state, motorial state and static position state respectively, The mean frequency slopes(MFslope, MFs), the flexion extension ratioratio(FER)and mean electromyogram amplitude were measured in both the epileptic and contralateral sides of paraspinal muscles, and organized the test data for statistical analysis. Results: the attenuation of MFs in the epileptic side of MFs decreased significantly compared with that before treatment(P<0.05) in 1 month, 3 months and 6 months after the PLDD, while there was no obvious change in the attenuation of the contralateral side;there was no significant change in mean EMG amplitude of contralateral side after PLDD, and the amplitude of the epileptic side increased, but the difference was not remarkably. the epileptic side FER=0.46±0.13, and FER=0.89±0.19 before treatment, the difference was conspicuous(P<0.05), the attenuation of FER in contralateral side was not striking changed. Conclusion: percutaneous lasers disk deoompression in the treatment of lumbar disc herniation can significantly improve paraspinal muscle fatigue, dysfunction, dysequilibrium and other pathological status, and effectively restore the intensity、equilibrium and coordination of paraspinal muscle;It is of clinical significance for efficacious evaluation of sEMG monitoring and prognosis of the disease after LDH treatment.

关 键 词：经皮激光椎间盘减压术 腰椎间盘突出症 椎旁肌 电活动规律 

分 类 号：R681.53[医药卫生—骨科学]