剪切波弹性成像动态评估动留针法治疗脑卒中后痉挛性偏瘫患者上肢痉挛效果  

Shear wave elastography in dynamic evaluation on therapeutic effect of dynamic needle retention for treating upper limb spasm in spastic hemiplegia patients after stroke

作　　者：黄珊珊 冉海涛[1] 苟春雁 HUANG Shanshan;RAN Haitao;GOU Chunyan(Department of Ultrasound,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China;Department of Ultrasound,Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China;Department of Acupuncture,Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China)

机构地区：[1]重庆医科大学附属第二医院超声科,重庆400010 [2]重庆市中医院超声科,重庆400021 [3]重庆市中医院针灸科,重庆400021

出　　处：《中国医学影像技术》2022年第10期1540-1544,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察剪切波弹性成像(SWE)动态评估动留针法治疗脑卒中后痉挛性偏瘫患者上肢痉挛效果的价值。方法纳入60例脑卒中后痉挛性偏瘫患者,分为观察组和对照组各30例,根据病情予以改善代谢、循环等基础治疗及常规康复训练,观察组同时以动留针术对患侧上肢肩前穴、青灵穴及尺泽穴进行治疗。分别于治疗前和治疗第7、14、21、28天对患侧上肢行SWE,测量痉挛肱肌和肱二头肌的杨氏模量平均值(E_(mean)),并以上肢改良Ashworth量表(MAS)进行评分。结果治疗第7、14、21、28天,2组肱肌和肱二头肌E_(mean)均较治疗前降低(P均<0.01)。治疗第21、28天,观察组肱肌和肱二头肌E_(mean)均较对照组降低(P均<0.01)。治疗第14、21、28天,观察组MAS评分低于治疗前,对照组MAS评分于治疗第21、28天低于治疗前(P均<0.01);治疗第21、28天,观察组MAS评分低于对照组(P均<0.05)。结论SWE可早期、动态评估以动留针法治疗脑卒中后痉挛性偏瘫患者上肢痉挛的效果,且较常规MAS评分更为敏感。Objective To explore the value of shear wave elastography(SWE)in dynamic evaluation on therapeutic effect of dynamic needle retention for treating upper limb spasm in spastic hemiplegia patients after stroke.Methods Sixty spastic hemiplegia patients after stroke were enrolled and divided into observed group and control group(each n=30).Basic treatments,such as improving metabolism and circulation were given according to patients condition,and routine rehabilitation trainings were performed.Dynamic needle retention was simultaneously performed at Jianqian,Qingling and Chize acupoints of the affected upper limbs in patients in observe group.SWE was used to measure the mean Young s modulus(E_(mean))of the spasmodic brachial muscle and biceps brachii before treatment and on the 7th,14th,21st,28th day of treatment.Meanwhile,the upper limb was rated with the modified Ashworth Scale(MAS).Results E_(mean) of the spasmodic brachial muscle and biceps brachii decreased on the 7th,14th,21st,28th day of treatment compared with before treatment in both groups(all P<0.01).E_(mean) of brachial muscle and biceps brachii were lower in observed group than that in control group on the 21st and 28th day of treatment(all P<0.01).MAS scores in observed group on the 14th,21st,28th day of treatment,MAS scores in control group on the 21st,28th day of treatment were all lower than those before treatment(all P<0.01).MAS scores decreased in observed group compared with that in control group on the 21st and 28st day of treatment(both P<0.05).Conclusion SWE could dynamically evaluate the therapeutic effect of dynamic needle retention on upper limb spasm in spastic hemiplegia patients after stroke,being more sensitive than conventional MAS score.

关 键 词：肌痉挛状态 上肢 弹性成像技术 动留针术 

分 类 号：R746.9[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]