下颌骨骨折患者围术期咀嚼肌肌电变化的初步研究  

A Primary Study of the Masticatory Function Change in the Perioperative Peroid of Mandible Fractures by Electromyogram

作　　者：史俊[1] 徐兵[1] 唐友盛[1] 

机构地区：[1]上海第二医科大学附属第九人民医院口腔医学院口腔颌面外科,上海200011

出　　处：《中国口腔颌面外科杂志》2003年第4期205-208,共4页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的通过测试咬肌、颞肌和翼外肌的肌电图,评价下颌骨骨折治疗前后咀嚼肌功能的变化及治疗效果,并动态观察咀嚼肌功能的恢复过程。方法收集下颌骨单侧骨折病例20例,利用肌电图仪分别测定术前、术后第7天和随访1个月后的咬肌、颞肌和翼外肌的肌电变化情况。通过轻收缩时记录到的运动单位电位的波峰和时限,以及最大收缩时募集电位的大小,分别进行不同测定阶段之间的两两比较,得出肌功能的变化情况,对咀嚼肌功能进行客观评价。结果20例单侧下颌骨骨折病例,治疗前测定各肌的各个指标,健侧较患侧均高;经配对t检验对两侧各指标进行比较,差别无显著性。经过开放复位内固定治疗后,测定各肌肉的各个指标,健侧和患侧较术前都有提高,尤其在一个月后有明显增高,经配对t检验比较不同阶段的指标,差别显著。结论测定肌电图可以客观地了解术后肌功能的变化,为外伤手术后的康复治疗提供明确的指标。下颌骨骨折的患者经手术切开复位内固定治疗后,咬肌、颞肌和翼外肌功能均都有明显提高,主要表现在术后1个月,而在手术后1周无明显变化。下颌骨骨折对于同侧和对侧肌均有影响,而对同侧肌的影响比健侧明显高。Objective During the treatment and rehabilitation period of the patients suffered from unilateral mandibular fractures, we evaluated the function of the lateral pterygoid, temporalis and masseter by electromyogram.On the basis of this digital measurement, we compared the electromyogram of the same muscles in the seperated phrases, before operation and seven days and one month after operation to observe the recovery of masticatory function dynamically and evaluate the result of the treatment.Methods From September, 1999 to March 2000, there were 20 patients suffering from mandible fractures, receiving surgical treatment. All the patients were treated by open reduction and internal fixation. We estimated the function of their bilateral lateral pterygoids, temproalises and masseters using the multimedia EMG/EP system. The Lasting Time of MUP (motor unit potential) was recorded in gentle contraction, and the Amplitude of the Recruitment recorded in maximal contraction. Through the comparison of these two indexes in different phrases and muscles, the changing of the masticatory function was evaluated.Results The means of the data which was about two indexes of three different muscles, totally in twenty patients (n=20), achieved in the healthy side before operation were higher than those in the injured side; but this difference analyzed by Paired t Test was not significant statistically (P>0.05). Comparing the data achieved one month after the operation with that recorded before operation both in the injured side and in the healthy side, the latter are much higher than the former; both the differences were evident statistically (P<0.05). While the improvement of the data achieved one week after the operation was not significant compared with that acquired before operation (P>0.05).Conclusion EMG is a good and objective mean to understand the functional changing of the muscles, it offers an unequivocal index for the rehabilitation therapy after trauma as well. The function of the masseter, temporalis and lateral pt

关 键 词：下颌骨 骨折 肌电图 

分 类 号：R782.4[医药卫生—口腔医学]