健康人腭帆张肌的肌电生理研究

发布时间：2018-01-31 19:01

本文关键词： 腭帆张肌肌电图肌电参数　出处：《广西医科大学》2007年硕士论文　论文类型：学位论文

【摘要】： 目的:建立同步双侧TVP的肌电图检查方法。取得健康人TVP的肌电数值,分析健康人TVP的EMG图形特点,并对不同扎入点、空吞咽和含水吞咽EMG各肌电参数进行比较,以寻求其规律及特点。方法:随机选择20名年龄在24～36周岁健康人志愿者进行双侧TVP的EMG分析。入选标准为:无中耳炎、鼻咽肿瘤、鼻咽炎等病史,无耳内闷涨感、听音遥远等症状,纯音测听、声导抗检查结果正常,行鼻内窥镜检查及耳内镜检查无异常。在进行鼻腔粘膜收缩及表面麻醉后,经由鼻内窥镜介导下,将同心圆电极针置入TVP不同扎入点,嘱受试者进行一系列的空吞咽以及含水吞咽动作,选择9名受试者进行空吞咽与含水吞咽引发TVP收缩时EMG比较,记录所有吞咽时TVP的EMG波形。随机选择6名受试者进行不同位置的TVP扎入点的EMG比较。结果:采集20名受试者38侧TVP的EMG。(1)计算出肌电参数为:TVP收缩持续时间为(0.863±0.255)S,收缩产生的峰电压为(445.100±246.808)μV,其EMG波型为干扰相,吞咽时,双侧TVP收缩同步,未观察到滞后现象。动作电位时程为(9.142±2.178)ms,动作电位的振幅为(254.260±191.544)μV,动作电位图形多为2～3相波形。 (2)分析6名受试者单侧TVP三个位置的EMG,并对肌电参数(收缩持续时间、收缩峰电压、动作电位时程、动作电位振幅)两两比较,差别均无统计学意义(P＞0.05)。但是在比较EMG图形的稳定上上点优于中点、下点两点。 (3)对9名受试者双侧TVP空吞咽与含水吞咽的肌电参数进行两两比较,发现各参数间均无统计学意义上的差别(P＞0.05)。说明,无论是空吞咽还是定量含水吞咽,引发的TVP肌的收缩效能是没有差别的。比较TVP收缩EMG波形,在分析TVP的动作电位时,扫描速度调为5ms/div,发现含水吞咽的EMG波形较空吞咽的EMG波形更稳定于基线,更易于提取单个动作电位并分析数值数值。吞咽时,两侧TVP同步收缩,但还不能得出双侧TVP肌电生理生理上完全对称的结论,而在以后的疾病研究中,应考虑以时限、相位以及动作电位募集的形式这些稳定的指标来比较。结论:(1)实验所得健康人TVP的肌电参数范围:收缩持续时间为(0.863±0.255)S,收缩产生的峰电压为(445.100±246.808)μV,其EMG波型为干扰相,吞咽时,双侧TVP收缩同步,无滞后现象。动作电位时程为(9.142±2.178)ms;动作电位的振幅为(254.260±191.544)μV;动作电位图形多为2～3相波形。 (2)充分的鼻腔粘膜收缩、麻醉,选择上点作为记录位点,定量含水吞咽时行双通道同步采集两侧TVP的EMG,是进行TVP的EMG研究较为合理的方式。
[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 卤0. 255s, the duration of contraction was 0. 863 卤0. 255s. The peak voltage of contraction was 445.100 卤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 卤2.178ms.The amplitude of action potential was 254.260 卤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 卤0.255S. the duration of contraction is 0.863 卤0.255S. The peak voltage of contraction was 445.100 卤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 卤2.178 Ms; The amplitude of action potential was 254.260 卤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.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R33

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