应用肌电图电刺激器治疗面肌痉挛-第三军医大学学报.DOC

应用肌电图电刺激器治疗面肌痉挛 刘云峰，冯海燕 摘要：目的：探讨经皮神经肌肉电刺激治疗面肌痉挛的临床价值。方法：42例原发性面肌痉挛患者在肌电图监测下行电刺激治疗3个月，分别于治疗前后行Cohen分级评价和侧方扩散反应LSR（Lateral spread response）检测，比较治疗前后两指标变化情况。结果：共入组42例患者，治疗前Cohen分级Ⅰ级5例，Ⅱ级17例，Ⅲ级11例，Ⅳ级9例，治疗后Cohen分级0级13例，Ⅰ级14例，Ⅱ级8例，Ⅲ级5例，Ⅳ级2例，痊愈率31.0%，有效率92.9%。治疗前后0-Ⅳ级患者构成比较Wilcoxon秩和检验，uC=5.15，P0.001。治疗前LSR阳性率95.24%，治疗后LSR阳性率45.24%，χ2=25.11，P0.005，治疗前后比较阳性率下降具有统计学意义。结论：肌电图监测下神经肌肉电刺激治疗面肌痉挛有效，无明显副作用，是一种治疗面肌痉挛的新方法。 关键词：面肌痉挛；经皮电刺激；肌电图 Electromyography electrical stimulator in the treatment of Hemifacial spasm Liu Yun-feng,Feng Hai-yan Abstract:Objectives:To explore the curative effect of transcutaneous electrical nerve and muscle stimulation in treatment of hemifacial spasm.Methods:42 patients with hemifacial spasm were given transcutaneous electrical nerve and muscle stimulation under monitoring of electromyography for 3 month, evaluate the degree of Cohen classification while detecte LSR（Lateral spread response）,the results before and after treatment were compared.Results:A total of 48 patients enrolled,include of Cohen classification level Ⅰ 5cases, level Ⅱ 17cases, level Ⅲ 11cases, level Ⅳ 9cases.After 3month treatment the degree of Cohen classification level 0 13cases level Ⅰ 14cases, level Ⅱ 8cases, level Ⅲ 5cases, level Ⅳ 2cases. The cure rate is 31.0%,total effective rate is 92.9%. The constituent ratio of Cohen classification level 0-Ⅳ after treatment than before by Wilcoxon rank sum test,uC=5.15，P0.001.The positive rate of LSR after treatment was 95.24% to compare before treatment 45.24%,χ2=25.11，P0.005. The positive rate of LSR after treatment,there were statistically significant. after treatment.Conclusion:Transcutaneous electrical nerve and muscle stimulation is clearly effective and new method on the treatment of hemifacial spasm under monitoring of electromyography，with no apparent side effects. Key words:Hemifacial spasm;Transcutaneous electrical nerve stimulation; Electromyogram 面肌痉挛HFS (Hemifacial spasm)人群发病率约为10-11/10万，临床表现为一侧面神经所支配的面部表情肌群不自主、阵发性、无痛性抽搐运动，通常开