表面肌电图技术在卒中后咽期吞咽功能障碍评估中的应用研究

发布时间：2018-12-14 07:31

【摘要】：目的：应用表面肌电图（Surface Electromyography，sEMG）技术与分析系统，探讨正常受试者和脑卒中后吞咽障碍患者（post-stroke dysphagia，PSD）咽期吞咽过程中颏下肌群和舌骨下肌群肌电活动的平均振幅和持续时间的差异。方法：本实验收集正常对照组（健康成人组，30例），病例组（PSD确诊患者组，30例)，对患者临床资料进行收集。采用芬兰Megawin6000-T8型表面肌电图仪采集两组受试者在静息状态、空吞咽、吞咽5ml水时两组肌群的表面肌电信号，分析出平均振幅（AEMG）和持续时间两个指标，比较两组之间有无统计学差异。结果：①静息状态下：病例组和对照组颏下肌群和舌骨下肌群的平均振幅均无统计学差异（P㧐0.05）；病例组：颏下肌群和舌骨下肌群肌电活动的平均振幅相比无统计学差异（P㧐0.05）；对照组：颏下肌群和舌骨下肌群肌电活动的平均振幅也无统计学差异（P㧐0.05）。②空吞咽状态下：颏下肌群的平均振幅和持续时间比较，病例组较对照组平均振幅升高，持续时间延长，且具有统计学差异（P㩳0.05）；舌骨下肌群的平均振幅和持续时间比较，病例组较对照组平均振幅明显升高，持续时间明显延长，且具有统计学差异（P㩳0.05）；③吞咽5ml水状态下：病例组两组肌群肌电活动的平均振幅较对照组平均振幅显著升高（p㩳0.005）；病例组两组肌群肌电活动的持续时间较对照组持续时间显著延长（p㩳0.001）；④组内之间比较：对照组：颏下肌群和舌骨下肌群平均振幅和持续时间在空吞咽和吞咽5ml水状态下均无统计学差异（P㧐0.05）;病例组：颏下肌群和舌骨下肌群平均振幅和持续时间在空吞咽和吞咽5ml水状态下均无统计学差异（P㧐0.05）。结论：sEMG技术可以作为一种无创、简单、快速检测咽期吞咽过程中相关肌群肌电活动的方法，通过颏下肌群和舌骨下肌群肌电活动的平均振幅和持续时间可以初步筛查和评估吞咽功能，反映舌骨上抬和喉上抬的难易程度和持续时间，评估患者完成此动作的神经肌肉的功能状态，预测吞咽障碍患者误吸的风险。
[Abstract]:Objective: to study the surface electromyography (Surface Electromyography,sEMG) technique and analysis system in normal subjects and patients with dysphagia after stroke (post-stroke dysphagia,). PSD) the mean amplitude and duration of myoelectric activity in submental and subhyoid groups during pharyngeal swallowing. Methods: normal control group (30 healthy adults, 30 cases) and case group (PSD group, 30 cases) were collected. The surface electromyography (EMG) of two groups of subjects were collected by using Finnish Megawin6000-T8 surface electromyography in resting state, empty swallowing and swallowing 5ml water. The mean amplitude (AEMG) and duration were analyzed. There were statistical differences between the two groups. Results: (1) there was no significant difference in the mean amplitude of submental muscle group and subhyoid muscle group between the case group and the control group under resting state (P0. 05). In the case group, there was no significant difference in the mean amplitude of myoelectric activity between submental group and subhyoid group (P0. 05). The mean amplitude of myoelectric activity in submental group and subhyoid group was not significantly different (P0. 05). 2 under empty swallowing, the mean amplitude and duration of submental muscle group were higher than that of control group. The duration was prolonged and there was statistical difference (P0. 05). Compared with the control group, the mean amplitude and duration of subhyoid muscle group in the case group were significantly higher than those in the control group, and the duration was significantly prolonged (P0. 05). 3 under the condition of swallowing 5ml water, the mean amplitude of myoelectric activity in the two groups was significantly higher than that in the control group (p0. 005). The duration of myoelectric activity in the two groups was significantly longer than that in the control group (p0. 001). Comparison among the four groups: in the control group, the mean amplitude and duration of submental and subhyoid muscle groups were not significantly different under the condition of empty swallowing and swallowing 5ml water (P0. 05). In the case group, the mean amplitude and duration of submental and subhyoid muscle groups were not significantly different between empty swallowing and swallowing 5ml water (P0. 05). Conclusion: sEMG can be used as a noninvasive, simple and rapid method for the detection of myoelectric activity in pharyngeal swallowing. The mean amplitude and duration of myoelectric activity in submental and subhyoid muscles can be preliminarily screened and evaluated to reflect the degree of difficulty and duration of hyoid and laryngeal elevation. To assess the neuromuscular function of the patient who completed the action and predict the risk of misprision in patients with dysphagia.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R743.3

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