徐冬梅 刘华

摘要：目的  研究肌电反馈功能性电刺激治疗急性期脑梗死手功能障碍的临床效果。方法  抽取新余市人民医院康复医学科2017年8月～2018年2月内接诊的急性期脑梗死手功能障碍患者90例，随机分为对照组和观察组，每组45例。对照组给予常规康复治疗，观察组加用肌电反馈功能性电刺激治疗，比较两组治疗前及治疗后不同时间点上肢运动功能评分变化、日常生活能力评分变化以及10s抓握测试情况。结果  观察组治疗2、4、8周后上肢运动功能评分均高于对照组，差异有统计学意义（P<0.05）;两组日常生活能力评分均有所上升，观察组患者评分高于对照组，差异有统计学意义（P<0.05）;观察组患者10s抓握测试次数高于对照组，差异有统计学意义（P<0.05）。结论  肌电反馈功能性电刺激治疗急性期脑梗死手功能障碍疾病有助于提高患者上肢运动功能和日常生活能力，增加10s抓握测试次数，促进恢复。

关键词：肌电反馈功能性电刺激;急性期脑梗死;手功能障碍;肩手综合征;康复治疗

Abstract：Objective  To study the clinical effect of electromyography feedback functional electrical stimulation on acute cerebral infarction with hand dysfunction. Methods  A total of 90 patients with acute cerebral infarction and hand dysfunction who were admitted to the Department of Rehabilitation Medicine of Xinyu People's Hospital from August 2017 to February 2018 were randomly divided into the control group and the observation group， with 45 cases in each group. The control group received routine rehabilitation treatment， and the observation group was treated with electromyography feedback functional electrical stimulation. The changes of upper limb motor function scores， daily living ability scores and 10s grip test were compared before and after treatment.Results  After treatment， the upper limb motor function scores of the observation group were higher than those of the control group at 2， 4， and 8 weeks， the difference was statistically significant （P<0.05）; the scores of daily living ability of both groups increased， the scores of the observation group were higher than the control group， the difference was statistically significant （P<0.05）; the number of 10s grip test in the observation group compared with the control group， the difference was statistically significant （P<0.05）.Conclusion  Electromyography feedback functional electrical stimulation for acute cerebral infarction with hand dysfunction can improve the upper limb motor function and daily living ability， increase the number of 10s grip test and promote recovery.

Key words：Electromyography feedback functional electrical stimulation therapy;Acute phase cerebral infarction;Hand dysfunction;Shoulder hand syndrome;Rehabilitation

急性脑梗死患者手功能障碍是常见的临床表现，主要是由于大脑皮质手功能区域激活不足所致，严重影响患者手运动功能的恢复，并且对患者预后情况造成严重威胁，应高度重视并尽早给予相关治疗措施，从而提高患者生命质量。研究证明[1]，对该病应用神经肌肉电刺激（NMES）治疗效果较佳，很好的诱发肌肉活动从而促进患者手功能恢复。基于此，本文選取本院90例患者展开研究，现报道如下。

1资料与方法

1.1一般资料  选取新余市人民医院康复医学科2017年8月～2018年2月内接诊的急性期脑梗死手功能障碍患者90例，采用随机数字表法分为对照组和观察组，各45例。对照组男20例，女25例;年龄59～72岁，平均年龄（68.56±2.45）岁。观察组男22例，女23例，年龄60～72岁，平均年龄（68.55±2.25）岁，两组性别、年龄比较，差异无统计学意义（P>0.05），研究可行。本研究经过医院伦理委员会审批，患者及家属知情同意并签署同意书。