功能性電刺激恢復周圍性面癱兔眨眼功能的研究
發(fā)布時間：2018-10-23 11:21
【摘要】：背景 周圍性面癱是由面神經(jīng)功能部分或完全喪失所引起的一組癥狀,它嚴重地影響著患者的身心健康。在周圍性面癱引起的所有癥狀中,眨眼功能障礙是最嚴重的,因為它不但影響美觀,同時還會帶來一系列嚴重的并發(fā)癥。盡管眼輪匝肌癱瘓導致的眨眼功能障礙會帶來嚴重的后果,但是目前對其尚無滿意且有效的治療方法。功能性電刺激(functional electrical stimulation, FES)在恢復癱瘓肌肉的運動功能方面具有顯著優(yōu)勢,其在臨床中應用已超過半個多世紀。很多科學家也嘗試將FES用于治療周圍性面癱,并在這方面進行了大量研究,但其尚未應用于臨床。 目的 1、以新西蘭白兔為模型,探索不同波形和參數(shù)的電刺激誘發(fā)眨眼運動的效果。 2、探索FES系統(tǒng)恢復單側(cè)周圍性面癱雙側(cè)同步眨眼功能的可行性。 3、探討慢性電刺激在延緩失神經(jīng)支配眼輪匝肌萎縮的機制。 方法 1、新西蘭白兔24只,切斷其右側(cè)面神經(jīng)做成單側(cè)周圍性面癱模型。用不同波形和參數(shù)的脈沖電流分別對雙側(cè)眼輪匝肌進行刺激,誘發(fā)眨眼運動。比較波形和刺激參數(shù)在脈沖刺激誘發(fā)眨眼運動中的效果。 2、取單側(cè)周圍性面癱的新西蘭白兔6只,用生理記錄儀記錄健側(cè)眼輪匝肌的肌電信號,并以此為觸發(fā)信號,觸發(fā)數(shù)字刺激器對癱瘓側(cè)眼輪匝肌的電刺激。用棉簽刺激健側(cè)眼瞼,誘發(fā)其眨眼,同時觀察癱瘓側(cè)眼瞼的反應。 3、根據(jù)第一部分的實驗結(jié)果,選擇眼輪匝肌電刺激的最佳波形和參數(shù),對6只雙側(cè)周圍性面癱白兔的左側(cè)眼輪匝肌進行慢性刺激,右側(cè)作為對照不進行刺激。刺激結(jié)束后測試雙側(cè)眼輪匝肌的興奮性,然后取眼輪匝肌做HE染色、免疫組化和透射電鏡檢查,觀察肌纖維、肌動蛋白和肌球蛋白以及肌肉超微結(jié)構的變化。 結(jié)果 1、載波頻率為25Hz時,脈沖刺激不能誘發(fā)平滑的眨眼運動。100Hz的脈沖刺激誘發(fā)眨眼所需的電壓小于50Hz,但是其消耗的電荷量遠高于后者。方波誘發(fā)完全眨眼所需的閾電壓遠小于其它兩種波形,而其消耗的總電荷量與另外兩種波形差異較小。 2、用FES系統(tǒng)能夠穩(wěn)定地記錄到健側(cè)眨眼時的肌電活動信號,并且成功觸發(fā)對癱瘓側(cè)眼輪匝肌的電刺激,在健側(cè)眨眼時,癱瘓側(cè)也同時發(fā)生了眨眼運動。 3、對照組的眼輪匝肌在失神經(jīng)支配82天后,其興奮性降低,肌纖維直徑和橫截面積明顯減小,肌球蛋白和肌動蛋白表達減少,細胞器變性,肌節(jié)、肌絲顯示不清。而接受慢性電刺激的實驗組眼輪匝肌,其興奮性較刺激前未發(fā)生明顯變化,其萎縮和變性的表現(xiàn)也明顯輕于對照組。 結(jié)論 1、50Hz的方波脈沖是刺激眼輪匝肌誘發(fā)眨眼的最佳選擇。 2、用健側(cè)眼輪匝肌的肌電信號作為對患側(cè)眼輪匝肌電刺激的觸發(fā)信號,可以恢復單側(cè)周圍性面癱兔的雙側(cè)同步眨眼,這為FES治療周圍性面癱提供了理論基礎。 3、慢性電刺激能夠有效預防由于失神經(jīng)支配導致的眼輪匝肌萎縮、變性。
[Abstract]:Background A group of symptoms caused by partial or complete loss of facial nerve, which seriously affects the body's mind and mind. Health. Eye blink dysfunction is the most severe in all of the symptoms caused by peripheral neuritis, as it affects not only aesthetics but also a series of serious problems Hair disorder, despite the serious consequences of eye blink dysfunction caused by paralysis of the eye, is currently not satisfactory and effective. Methods: Functional electrical stimulation (FES) has a significant advantage in restoring the motor function of paralyzed muscles, which has been applied more than half in clinic. In the 21st century, many scientists have also attempted to use FES in the treatment of peripheral neuritis, and have done a lot of research in this respect, but they have not yet been applied Clinical Objective 1 To explore the electrical stimulation of different waveforms and parameters using New Zealand white rabbits as model. 2. Explore the FES system to recover one-sided peripheral facial neuritis. feasibility of side-synchronous blink function. 3. Discuss chronic electrical stimulation in delaying To lose sight of God A mechanism to control the amyotrophy of the eyes of the eye. Methods 1, 24 New Zealand white rabbits and cutting off the right facial nerve to form a single-sided peripheral facial paralysis model, wherein the pulse current with different waveforms and parameters is used for cutting off the facial nerve, To stimulate the double-lateral eye's muscle, induce the blink, and compare the waveform. and using a physiological recorder to record the myoelectric signals of the vital-side eye wheel turn muscle, Signaling, triggering the electrical stimulation of the digital stimulator to the ophthalmoplegia on the paralyzed side. Irritation with a cotton swab. 3. According to the experimental results of the first part, the best waveform and parameters of electric stimulation of the turn muscle of the eye were selected. Chronic stimulation was performed on the left eye of the rabbit, and the right side was not stimulated as a control. After the stimulation was completed, the excitability of the two-sided eye-turn muscle was tested, and then the eye wheel turns were taken as HE stain, immunohistochemistry and transmission electron microscopy. observation The changes of muscle fiber, actin and tropomyosin and muscle ultrastructure. Results 1. When the carrier frequency is 25Hz, the pulse stimulation can not induce smooth blink motion. 100Hz pulse The voltage required to stimulate the blink is less than 50Hz, but the amount of charge it consumes is much higher than the latter. The square wave induces a threshold required for a complete blink the voltage is much smaller than the other two waveforms, and the total amount of charge consumed is smaller than that of the other two waveforms. Triggering the electrical stimulation of the ophthalmoplegia on the side of the paralyzed side, the eye blink at the palsy side at the time of the key-side winking. 3. The eye wheel turn muscle of the control group decreased the excitability, the diameter of the muscle fibers after the loss of nerve for 82 days. The cross-sectional area is obviously reduced, the expression of tropomyosin and actin is reduced, the cell organelles are denatured, the muscle segment and the myofilament are not clear, and the experimental group receiving the chronic electrical stimulation eye wheel There was no significant change in the excitability of the ularis muscle before it was stimulated, and its atrophy and degeneration were observed. Conclusion 1, 50Hz square wave pulse is the best option to stimulate the blink of the eye. The stimulated trigger signal can be used to recover the double-side synchronous blink of the unilateral peripheral vascular rabbit, which is FES.
【學位授予單位】：北京協(xié)和醫(yī)學院
【學位級別】：博士
【學位授予年份】：2014
【分類號】：R745.12
本文編號：2289073
[Abstract]:Background A group of symptoms caused by partial or complete loss of facial nerve, which seriously affects the body's mind and mind. Health. Eye blink dysfunction is the most severe in all of the symptoms caused by peripheral neuritis, as it affects not only aesthetics but also a series of serious problems Hair disorder, despite the serious consequences of eye blink dysfunction caused by paralysis of the eye, is currently not satisfactory and effective. Methods: Functional electrical stimulation (FES) has a significant advantage in restoring the motor function of paralyzed muscles, which has been applied more than half in clinic. In the 21st century, many scientists have also attempted to use FES in the treatment of peripheral neuritis, and have done a lot of research in this respect, but they have not yet been applied Clinical Objective 1 To explore the electrical stimulation of different waveforms and parameters using New Zealand white rabbits as model. 2. Explore the FES system to recover one-sided peripheral facial neuritis. feasibility of side-synchronous blink function. 3. Discuss chronic electrical stimulation in delaying To lose sight of God A mechanism to control the amyotrophy of the eyes of the eye. Methods 1, 24 New Zealand white rabbits and cutting off the right facial nerve to form a single-sided peripheral facial paralysis model, wherein the pulse current with different waveforms and parameters is used for cutting off the facial nerve, To stimulate the double-lateral eye's muscle, induce the blink, and compare the waveform. and using a physiological recorder to record the myoelectric signals of the vital-side eye wheel turn muscle, Signaling, triggering the electrical stimulation of the digital stimulator to the ophthalmoplegia on the paralyzed side. Irritation with a cotton swab. 3. According to the experimental results of the first part, the best waveform and parameters of electric stimulation of the turn muscle of the eye were selected. Chronic stimulation was performed on the left eye of the rabbit, and the right side was not stimulated as a control. After the stimulation was completed, the excitability of the two-sided eye-turn muscle was tested, and then the eye wheel turns were taken as HE stain, immunohistochemistry and transmission electron microscopy. observation The changes of muscle fiber, actin and tropomyosin and muscle ultrastructure. Results 1. When the carrier frequency is 25Hz, the pulse stimulation can not induce smooth blink motion. 100Hz pulse The voltage required to stimulate the blink is less than 50Hz, but the amount of charge it consumes is much higher than the latter. The square wave induces a threshold required for a complete blink the voltage is much smaller than the other two waveforms, and the total amount of charge consumed is smaller than that of the other two waveforms. Triggering the electrical stimulation of the ophthalmoplegia on the side of the paralyzed side, the eye blink at the palsy side at the time of the key-side winking. 3. The eye wheel turn muscle of the control group decreased the excitability, the diameter of the muscle fibers after the loss of nerve for 82 days. The cross-sectional area is obviously reduced, the expression of tropomyosin and actin is reduced, the cell organelles are denatured, the muscle segment and the myofilament are not clear, and the experimental group receiving the chronic electrical stimulation eye wheel There was no significant change in the excitability of the ularis muscle before it was stimulated, and its atrophy and degeneration were observed. Conclusion 1, 50Hz square wave pulse is the best option to stimulate the blink of the eye. The stimulated trigger signal can be used to recover the double-side synchronous blink of the unilateral peripheral vascular rabbit, which is FES.
【學位授予單位】：北京協(xié)和醫(yī)學院
【學位級別】：博士
【學位授予年份】：2014
【分類號】：R745.12
【參考文獻】
相關期刊論文 前1條
1 徐建廣,顧玉東,李繼峰;大鼠失神經(jīng)支配骨骼肌退變的實驗研究[J];上海醫(yī)科大學學報;1999年04期
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