本文關(guān)鍵詞： 腭帆張肌 肌電圖 肌電參數(shù)　出處：《廣西醫(yī)科大學(xué)》2007年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的:建立同步雙側(cè)TVP的肌電圖檢查方法。取得健康人TVP的肌電數(shù)值,分析健康人TVP的EMG圖形特點(diǎn),并對(duì)不同扎入點(diǎn)、空吞咽和含水吞咽EMG各肌電參數(shù)進(jìn)行比較,以尋求其規(guī)律及特點(diǎn)。 方法:隨機(jī)選擇20名年齡在24～36周歲健康人志愿者進(jìn)行雙側(cè)TVP的EMG分析。入選標(biāo)準(zhǔn)為:無中耳炎、鼻咽腫瘤、鼻咽炎等病史,無耳內(nèi)悶漲感、聽音遙遠(yuǎn)等癥狀,純音測(cè)聽、聲導(dǎo)抗檢查結(jié)果正常,行鼻內(nèi)窺鏡檢查及耳內(nèi)鏡檢查無異常。在進(jìn)行鼻腔粘膜收縮及表面麻醉后,經(jīng)由鼻內(nèi)窺鏡介導(dǎo)下,將同心圓電極針置入TVP不同扎入點(diǎn),囑受試者進(jìn)行一系列的空吞咽以及含水吞咽動(dòng)作,選擇9名受試者進(jìn)行空吞咽與含水吞咽引發(fā)TVP收縮時(shí)EMG比較,記錄所有吞咽時(shí)TVP的EMG波形。隨機(jī)選擇6名受試者進(jìn)行不同位置的TVP扎入點(diǎn)的EMG比較。 結(jié)果:采集20名受試者38側(cè)TVP的EMG。(1)計(jì)算出肌電參數(shù)為:TVP收縮持續(xù)時(shí)間為(0.863±0.255)S,收縮產(chǎn)生的峰電壓為(445.100±246.808)μV,其EMG波型為干擾相,吞咽時(shí),雙側(cè)TVP收縮同步,未觀察到滯后現(xiàn)象。動(dòng)作電位時(shí)程為(9.142±2.178)ms,動(dòng)作電位的振幅為(254.260±191.544)μV,動(dòng)作電位圖形多為2～3相波形。 (2)分析6名受試者單側(cè)TVP三個(gè)位置的EMG,并對(duì)肌電參數(shù)(收縮持續(xù)時(shí)間、收縮峰電壓、動(dòng)作電位時(shí)程、動(dòng)作電位振幅)兩兩比較,差別均無統(tǒng)計(jì)學(xué)意義(P＞0.05)。但是在比較EMG圖形的穩(wěn)定上上點(diǎn)優(yōu)于中點(diǎn)、下點(diǎn)兩點(diǎn)。 (3)對(duì)9名受試者雙側(cè)TVP空吞咽與含水吞咽的肌電參數(shù)進(jìn)行兩兩比較,發(fā)現(xiàn)各參數(shù)間均無統(tǒng)計(jì)學(xué)意義上的差別(P＞0.05)。說明,無論是空吞咽還是定量含水吞咽,引發(fā)的TVP肌的收縮效能是沒有差別的。比較TVP收縮EMG波形,在分析TVP的動(dòng)作電位時(shí),掃描速度調(diào)為5ms/div,發(fā)現(xiàn)含水吞咽的EMG波形較空吞咽的EMG波形更穩(wěn)定于基線,更易于提取單個(gè)動(dòng)作電位并分析數(shù)值數(shù)值。 吞咽時(shí),兩側(cè)TVP同步收縮,但還不能得出雙側(cè)TVP肌電生理生理上完全對(duì)稱的結(jié)論,而在以后的疾病研究中,應(yīng)考慮以時(shí)限、相位以及動(dòng)作電位募集的形式這些穩(wěn)定的指標(biāo)來比較。 結(jié)論:(1)實(shí)驗(yàn)所得健康人TVP的肌電參數(shù)范圍:收縮持續(xù)時(shí)間為(0.863±0.255)S,收縮產(chǎn)生的峰電壓為(445.100±246.808)μV,其EMG波型為干擾相,吞咽時(shí),雙側(cè)TVP收縮同步,無滯后現(xiàn)象。動(dòng)作電位時(shí)程為(9.142±2.178)ms;動(dòng)作電位的振幅為(254.260±191.544)μV;動(dòng)作電位圖形多為2～3相波形。 (2)充分的鼻腔粘膜收縮、麻醉,選擇上點(diǎn)作為記錄位點(diǎn),定量含水吞咽時(shí)行雙通道同步采集兩側(cè)TVP的EMG,是進(jìn)行TVP的EMG研究較為合理的方式。
[Abstract]:Objective: to establish an electromyography (EMG) examination method for synchronous bilateral TVP. To obtain the myoelectric value of TVP in healthy people, analyze the EMG pattern of TVP in healthy people, and make different insertion points. The electromyoelectric parameters of empty swallowing and water swallowing EMG were compared in order to find out its regularity and characteristics. Methods: twenty healthy volunteers aged 24 ~ 36 years were randomly selected for EMG analysis of bilateral TVP. The selected criteria were: no history of otitis media, nasopharyngeal tumor, nasopharyngitis, etc. After nasal mucosa contraction and surface anesthesia, the results of pure tone audiometry and acoustic impedance examination were normal, nasal endoscopy and otoendoscopy were not abnormal. The concentric electrode needle was inserted into different points of TVP by nasal endoscope, and the subjects were asked to perform a series of empty swallowing and water swallowing. Nine subjects were selected to compare the EMG of empty swallowing with that of TVP induced by water-containing swallowing. All EMG waveforms of TVP were recorded during swallowing. Six subjects were randomly selected to compare EMG at different TVP insertion points. Results: the electromyoelectric parameters (EMG) of 38 sides of TVP in 20 subjects were calculated to be 0. 863 鹵0. 255s, the duration of contraction was 0. 863 鹵0. 255s. The peak voltage of contraction was 445.100 鹵246.808 渭 V. its EMG wave pattern was interference phase. During swallowing, bilateral TVP contraction was synchronous. No lag was observed. The duration of action potential was 9.142 鹵2.178ms.The amplitude of action potential was 254.260 鹵191.544 渭 V. Most of the action potential patterns are 2 ~ 3 phase waveforms. (2) EMG of 6 subjects with unilateral TVP were analyzed, and the electromyoelectric parameters (duration of contraction, peak voltage of contraction, duration of action potential, amplitude of action potential) were compared. The difference was not statistically significant (P > 0.05), but the upper point was better than the middle point and the next point was two points in comparing the stability of the EMG graph. (3) the electromyoelectric parameters of bilateral TVP empty swallowing and water swallowing in 9 subjects were compared in pairs. The results showed that there was no significant difference between the two parameters (P > 0.05). The results showed that there was no significant difference in EMG parameters between the two groups (P > 0.05). There was no difference in the contractility of TVP muscle induced by emptying or quantitative water swallowing. The contractile EMG waveforms of TVP were compared and the action potentials of TVP were analyzed. The scanning velocities were adjusted to 5 Ms / div, and it was found that the EMG waveform with water swallowing was more stable than the EMG waveform with empty swallowing, and it was easier to extract single action potential and analyze the numerical value. During swallowing, bilateral TVP constricts synchronously, but it is not possible to draw the conclusion that bilateral TVP electrophysiologically is completely symmetrical. However, the time limit should be considered in the future study of the disease. Phase and the form of action potential recruitment are stable indicators to compare. Conclusion the range of myoelectric parameters of TVP obtained from the experiment is 0.863 鹵0.255S. the duration of contraction is 0.863 鹵0.255S. The peak voltage of contraction was 445.100 鹵246.808 渭 V. its EMG wave pattern was interference phase. During swallowing, bilateral TVP contraction was synchronous. The action potential duration was 9.142 鹵2.178 Ms; The amplitude of action potential was 254.260 鹵191.544 渭 V; Most of the action potential patterns are 2 ~ 3 phase waveforms. 2) adequate nasal mucosal contraction and anaesthesia, the upper point was selected as the recording site, and the EMG of bilateral TVP was collected synchronously by two channels during quantitative swallowing. It is a reasonable way to do EMG research on TVP.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2007
【分類號(hào)】：R33

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