功能性电刺激恢复周围性面瘫兔眨眼功能的研究
发布时间：2018-10-23 11:21
【摘要】：背景 周围性面瘫是由面神经功能部分或完全丧失所引起的一组症状,它严重地影响着患者的身心健康。在周围性面瘫引起的所有症状中,眨眼功能障碍是最严重的,因为它不但影响美观,同时还会带来一系列严重的并发症。尽管眼轮匝肌瘫痪导致的眨眼功能障碍会带来严重的后果,但是目前对其尚无满意且有效的治疗方法。功能性电刺激(functional electrical stimulation, FES)在恢复瘫痪肌肉的运动功能方面具有显著优势,其在临床中应用已超过半个多世纪。很多科学家也尝试将FES用于治疗周围性面瘫,并在这方面进行了大量研究,但其尚未应用于临床。 目的 1、以新西兰白兔为模型,探索不同波形和参数的电刺激诱发眨眼运动的效果。 2、探索FES系统恢复单侧周围性面瘫双侧同步眨眼功能的可行性。 3、探讨慢性电刺激在延缓失神经支配眼轮匝肌萎缩的机制。 方法 1、新西兰白兔24只,切断其右侧面神经做成单侧周围性面瘫模型。用不同波形和参数的脉冲电流分别对双侧眼轮匝肌进行刺激,诱发眨眼运动。比较波形和刺激参数在脉冲刺激诱发眨眼运动中的效果。 2、取单侧周围性面瘫的新西兰白兔6只,用生理记录仪记录健侧眼轮匝肌的肌电信号,并以此为触发信号,触发数字刺激器对瘫痪侧眼轮匝肌的电刺激。用棉签刺激健侧眼睑,诱发其眨眼,同时观察瘫痪侧眼睑的反应。 3、根据第一部分的实验结果,选择眼轮匝肌电刺激的最佳波形和参数,对6只双侧周围性面瘫白兔的左侧眼轮匝肌进行慢性刺激,右侧作为对照不进行刺激。刺激结束后测试双侧眼轮匝肌的兴奋性,然后取眼轮匝肌做HE染色、免疫组化和透射电镜检查,观察肌纤维、肌动蛋白和肌球蛋白以及肌肉超微结构的变化。 结果 1、载波频率为25Hz时,脉冲刺激不能诱发平滑的眨眼运动。100Hz的脉冲刺激诱发眨眼所需的电压小于50Hz,但是其消耗的电荷量远高于后者。方波诱发完全眨眼所需的阈电压远小于其它两种波形,而其消耗的总电荷量与另外两种波形差异较小。 2、用FES系统能够稳定地记录到健侧眨眼时的肌电活动信号,并且成功触发对瘫痪侧眼轮匝肌的电刺激,在健侧眨眼时,瘫痪侧也同时发生了眨眼运动。 3、对照组的眼轮匝肌在失神经支配82天后,其兴奋性降低,肌纤维直径和横截面积明显减小,肌球蛋白和肌动蛋白表达减少,细胞器变性,肌节、肌丝显示不清。而接受慢性电刺激的实验组眼轮匝肌,其兴奋性较刺激前未发生明显变化,其萎缩和变性的表现也明显轻于对照组。 结论 1、50Hz的方波脉冲是刺激眼轮匝肌诱发眨眼的最佳选择。 2、用健侧眼轮匝肌的肌电信号作为对患侧眼轮匝肌电刺激的触发信号,可以恢复单侧周围性面瘫兔的双侧同步眨眼,这为FES治疗周围性面瘫提供了理论基础。 3、慢性电刺激能够有效预防由于失神经支配导致的眼轮匝肌萎缩、变性。
[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.
【学位授予单位】：北京协和医学院
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R745.12
本文编号：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.
【学位授予单位】：北京协和医学院
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R745.12
【参考文献】
相关期刊论文 前1条
1 徐建广,顾玉东,李继峰;大鼠失神经支配骨骼肌退变的实验研究[J];上海医科大学学报;1999年04期
，本文编号：2289073
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