發(fā)布時(shí)間：2018-02-12 22:07

  本文關(guān)鍵詞： 脈沖波 功能性電刺激 周?chē)窠?jīng)損傷 治療儀 便攜式 臂叢神經(jīng)損傷　出處：《第四軍醫(yī)大學(xué)》2015年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:針對(duì)臂叢神經(jīng)損傷的神經(jīng)電刺激治療特點(diǎn),在成功研制用于單根周?chē)窠?jīng)損傷治療的單通道神經(jīng)電刺激治療儀并臨床驗(yàn)證的基礎(chǔ)上,研制用于臂叢神經(jīng)損傷治療的便攜式三通道臂叢神經(jīng)損傷電刺激治療儀,并應(yīng)用于臂叢神經(jīng)損傷患者,初步觀察臨床治療效果。方法:(1)在功能性電刺激的電生理學(xué)原理基礎(chǔ)上研制便攜式單通道神經(jīng)電刺激治療儀,系統(tǒng)硬件部分包括微控制器、電源模塊、顯示模塊、參數(shù)存儲(chǔ)模塊、電極脫落檢測(cè)電路、電池電壓檢測(cè)電路、高壓脈沖發(fā)生電路等七個(gè)基本模塊,系統(tǒng)軟件是基于ARM核硬件平臺(tái),通過(guò)軟件編程完成;通過(guò)軟件中的治療過(guò)程控制程序,實(shí)現(xiàn)了多種不同的刺激波形,經(jīng)表面自粘性電極片對(duì)脈沖波進(jìn)行輸出,作用于不同類(lèi)型的單根周?chē)窠?jīng)。(2)將65例單根周?chē)窠?jīng)(尺神經(jīng)20例,橈神經(jīng)20例,正中神經(jīng)25例)損傷術(shù)后的患者隨機(jī)分成試驗(yàn)組35例和對(duì)照組30例,試驗(yàn)組術(shù)后第2周拆線(xiàn)后使用研制的便攜式單通道神經(jīng)電刺激治療儀進(jìn)行治療,常規(guī)按時(shí)服用神經(jīng)營(yíng)養(yǎng)藥物及患肢主被動(dòng)功能鍛煉;對(duì)照組按時(shí)服用神經(jīng)營(yíng)養(yǎng)藥物及患肢主被動(dòng)功能鍛煉,患者術(shù)后3月、6月隨訪(fǎng),6月時(shí)觀察患者受損神經(jīng)功能恢復(fù)情況。(3)針對(duì)單通道神經(jīng)刺激治療儀一次只能針對(duì)單根神經(jīng)進(jìn)行治療的缺點(diǎn),結(jié)合臂叢神經(jīng)多組神經(jīng)損傷的特點(diǎn),研制便攜式三通道臂叢神經(jīng)損傷電刺激治療儀。儀器由主控模塊、顯示模塊、鍵盤(pán)模塊、三個(gè)通道的電刺激發(fā)生器模塊以及電源模塊,組成便攜式三通道電刺激系統(tǒng),釋放三組連續(xù)交替性電脈沖刺激,按照通道1、通道2、通道3連續(xù)交替性輸出,且每通道刺激持續(xù)周期為1-5分鐘。(4)將28例臂叢神經(jīng)上中干損傷術(shù)后的患者隨機(jī)分成試驗(yàn)組(15例)和對(duì)照組(13例),試驗(yàn)組術(shù)后第三周使用研制的便攜式三通道臂叢神經(jīng)損傷電刺激治療儀治療,對(duì)照組不做相關(guān)處理,患者術(shù)后8月時(shí)隨訪(fǎng),觀察患者上肢抬肩、屈肘、伸肘功能恢復(fù)情況。結(jié)果:(1)單根神經(jīng)損傷術(shù)后的患者,經(jīng)便攜式單通道神經(jīng)電刺激治療儀的治療,其優(yōu)良率均明顯好于對(duì)照組,且差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)臂叢神經(jīng)上中干損傷術(shù)后的患者,經(jīng)便攜式三通道臂叢神經(jīng)損傷電刺激治療儀的治療,其患側(cè)抬肩、屈肘、伸肘功能均好于治療前,差異明顯且有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:(1)便攜式單通道神經(jīng)電刺激治療儀可以有效地促進(jìn)單根神經(jīng)損傷術(shù)后神經(jīng)功能的康復(fù),且治療模式可以個(gè)體化調(diào)節(jié),成本低,使用靈活,具有專(zhuān)一性和安全性。(2)本研究研制成功的便攜式三通道臂叢神經(jīng)損傷電刺激治療儀,可以有效地促進(jìn)臂叢神經(jīng)上中干損傷后上肢功能的康復(fù),并且可以對(duì)三組神經(jīng)和肌肉進(jìn)行連續(xù)交替性神經(jīng)電刺激,具有較好的創(chuàng)新性,療效確切,方便患者使用,便于攜帶,集成治療的特點(diǎn),初步觀察患者恢復(fù)滿(mǎn)意。
[Abstract]:Objective: according to the characteristics of nerve electrical stimulation for brachial plexus injury, a single channel nerve stimulation apparatus for the treatment of single peripheral nerve injury was successfully developed and verified. A portable three-channel electric stimulation apparatus for brachial plexus injury was developed and used in patients with brachial plexus injury. Methods based on the electrophysiological principle of functional electrical stimulation, a portable single channel neuroelectric stimulation apparatus was developed. The hardware of the system includes microcontroller, power supply module, display module, and so on. There are seven basic modules, such as parameter storage module, electrode shedding detection circuit, battery voltage detection circuit and high voltage pulse generation circuit. The system software is based on the hardware platform of ARM core and is programmed by software. Through the therapeutic process control program in the software, a variety of different stimulation waveforms were realized. The pulse waves were output through the surface self-adhesive electrode plate, acting on the single peripheral nerve of different types. 65 cases of the single peripheral nerve (20 cases of ulnar nerve) were treated. 20 cases of radial nerve and 25 cases of median nerve) were randomly divided into experimental group (35 cases) and control group (30 cases). Routine routine use of neurotrophic drugs and active and passive function exercise of affected limbs, while the control group took neurotrophic drugs and active and passive function exercises of affected limbs on time, The patients were followed up on March and June, and the recovery of injured nerve function was observed on June) in view of the shortcoming that the single channel nerve stimulator could only treat single nerve at a time, combined with the characteristics of multiple groups of nerve injury of brachial plexus nerve. A portable three-channel electrical stimulation apparatus for brachial plexus injury was developed. The instrument consists of a main control module, a display module, a keyboard module, a three-channel electrical stimulation generator module and a power supply module, which constitute a portable three-channel electrical stimulation system. Release three groups of consecutive alternating electrical pulse stimuli, output in accordance with channel 1, channel 2, channel 3 continuously alternately, 28 cases of brachial plexus injury after middle trunk injury were randomly divided into trial group (n = 15) and control group (n = 13). The study group was treated with portable three-channel brachial plexus in the third week after operation. Treatment of nerve injury with electrical stimulation apparatus, The patients in the control group were followed up on August to observe the recovery of the function of shoulder lifting, elbow flexion and elbow extension. Results the patients with single nerve injury were treated with a portable single channel nerve stimulation apparatus. The excellent and good rates were significantly better than those in the control group, and the difference was statistically significant (P 0.05. 0. 0. 2) after the middle trunk injury of brachial plexus, the patients were treated with a portable three channel brachial plexus nerve injury electric stimulation apparatus. The elbow extension function was better than that before treatment, and the difference was significant (P 0.05). Conclusion the portable single channel nerve stimulation apparatus can effectively promote the recovery of nerve function after single nerve injury, and the treatment mode can be adjusted individually. The portable three-channel brachial plexus nerve injury electrical stimulation apparatus developed in this study can effectively promote the recovery of upper limb function after the middle trunk injury of brachial plexus nerve. Three groups of nerve and muscle can be continuously alternated nerve electrical stimulation, with better innovative, effective, convenient for patients to use, easy to carry, integrated treatment characteristics, preliminary observation of patients recovery satisfaction.
【學(xué)位授予單位】：第四軍醫(yī)大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R651.3

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相關(guān)期刊論文 前1條

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本文編號(hào)：1506666