表面肌电图在先天性肌性斜颈儿童中的诊断价值及临床应用  

Diagnostic value and clinical application of surface electromyography in children with congenital muscular torticollis

作　　者：冯雪菲 刘苑[2] 龚德志 成少华 陈玉霞[2] Feng Xue-Fei;Liu-Yuan;Gong De-Zhi;Chen Shao-Hua;Chen Yu-Xia(Department of Pediatrics,the First People's Hospital in Shuangliu District of Chengdu/West China Airport Hospital of Sichuan University,Chengdu,Sichuan 610200,China;Department of Rehabilitation,Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing 400014,China)

机构地区：[1]成都市双流区第一人民医院/四川大学华西空港医院儿科,四川成都610200 [2]重庆医科大学附属儿童医院康复科/国家儿童健康与疾病临床医学研究中心/儿童发育疾病研究教育部重点实验室,重庆400014

出　　处：《解放军医学杂志》2023年第12期1433-1438,共6页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨表面肌电图在先天性肌性斜颈(CMT)儿童颈部肌群中的肌电特征及临床应用价值。方法选取2018年6月-2022年8月在重庆医科大学附属儿童医院康复中心确诊为CMT的478例患儿进行回顾性分析。采用同一病例斜颈侧纳入患侧组、健侧纳入对照组的自身对照方法,采用表面肌电图记录静息和不同运动状态下双侧胸锁乳突肌、颈阔肌、斜方肌(上)的均方根(RMS)值,比较患侧与健侧肌群在静息及不同运动状态下的差异及诊断价值;采用Spearman相关系数评估患侧CMT严重程度与颈部各肌群的关系。结果CMT儿童患侧胸锁乳突肌RMS值在放松时高于健侧,收缩时低于健侧,差异均有统计学意义(P<0.05),患侧在静息坐位及各种运动状态下的RMS值异常均有较高诊断价值。患侧颈阔肌在静息坐位、反向转颈放松状态时的RMS值均高于健侧(P<0.05),同向转颈收缩状态时的RMS值均低于健侧(P<0.05),且在静息坐位、仰头时检测值异常具有较高价值。患侧斜方肌(上)在放松状态时RMS值高于健侧(P<0.05),在坐位、转颈及低头时的检测值异常具有较高检查价值。CMT的严重程度与胸锁乳突肌、颈阔肌、斜方肌(上)RMS值均呈正相关(r分别为0.721、0.612、0.655,P<0.001)。结论表面肌电图检查可作为CMT儿童临床诊断及疗效评估的一种较好的方法。Objective To investigate the EMG characteristics and clinical application value of surface EMG in cervical muscle group of children with congenital muscular torticollis(CMT).Methods A retrospective analysis was performed on 478 children diagnosed as CMT from January 2018 to August 2022 in Rehabilitation Center of the Children's Hospital Affiliated to Chongqing Medical University.The torticollis side of the same case was included in observation group and the healthy side was included in control group.Surface EMG was used to record the electromyography root-mean-square values of bilateral sternocleidomastoid muscles,platysma muscles and upper trapezius muscles in the rest and different exercise states.The difference of root-mean-square values between the affected side and the healthy side muscle groups at rest and under different exercise states and the diagnostic value were compared.Spearman correlation analysis was used to evaluate the relationship between the severity of congenital muscular torticollis on the affected side and the root mean square value of each cervical muscle group.Results The root-mean-square value of sternocleidomastoid muscle on the affected side of CMT children was higher than that on the healthy side during relaxation and lower than that on the healthy side during contraction,and the differences were statistically significant(P<0.05),the abnormal root-mean-square value of the affected side in the resting position and in all motion state has higher diagnostic value.The root-mean-square value of platysma muscle on the affected side was higher than that on the healthy side when it was in the resting position and the reverse neck rotation relaxed state(P<0.05),and lower than that on the healthy side when it was in the same neck rotation contraction state(P<0.05),abnormal values detected in resting sitting position and elevation of head have higher value.Root-mean-square value of upper trapezius muscle on the affected side was higher than that on the healthy side in the relaxed state(P<0.05).Th

关 键 词：先天性肌性斜颈 胸锁乳突肌 颈阔肌 斜方肌(上) 表面肌电图 均方根值 

分 类 号：R729[医药卫生—儿科]