先天性马蹄内翻足Ponseti法治疗后其表面肌电研究

发布时间：2018-11-02 20:07

【摘要】：【目的】先天性马蹄内翻足(congenital clubfoot,CCF)是儿童最常见的先天性四肢畸形之一,病因尚不清楚。本研究旨在探讨表面肌电检测技术在Ponseti治疗后先天性马蹄内翻足患儿中的临床意义。【方法】本研究采用十六通道表面肌电图遥测仪对Ponseti治疗后的8名单侧先天性马蹄内翻足患儿进行表面肌电检测,所有患儿均可自主平地行走9 m,在步态行进过程中同时测量患侧与对侧小腿胫前肌、腓肠肌内侧头、腓骨肌的表面肌电信号,利用美国Noraxon公司专用信号处理软件MyoResearch获得所测肌肉的平均振幅(μV)、平均频率(Hz)、中位频率(Hz),采用SPPSS16.0统计软件利用配对t检验分别比较患侧和对侧各表面肌电参数的差异。【结果】结果发现8名Ponseti治疗后的单侧先天性马蹄内翻足患儿在步态模式下其患侧胫前肌、腓肠肌内侧头和腓骨肌表面肌电图的平均振幅较对侧虽无明显统计学差异但具有临床意义。另外,8名患儿患侧胫前肌、腓肠肌内侧头、腓骨肌表面肌电的平均频率明显高于对侧(P0.05),患侧胫前肌和腓肠肌内侧头表面肌电的中位频率高位对侧(P0.05),而腓骨肌表面肌电的中位数频率无明显统计学差异。【结论】利用表面肌电检测技术对先天性马蹄内翻足患儿双侧小腿肌群的功能进行评估,可能为判断Ponseti治疗后先天性马蹄内翻足患儿的预后及何时需进一步手术治疗提供客观、可靠的依据。
[Abstract]:Objective: congenital equinovarus foot (congenital clubfoot,CCF) is one of the most common congenital extremities in children. The purpose of this study was to investigate the clinical significance of surface electromyography in children with congenital equinovarus after Ponseti treatment. [methods] Sixteen-channel surface electromyography telemeter was used to detect the congenital of 8 sides of Ponseti after Ponseti treatment. The surface electromyography was performed in children with equinovarus. All the children were able to walk on their own for 9 m.The surface electromyography of the affected and contralateral tibial anterior muscle, the medial gastrocnemius head and the fibula muscle were measured simultaneously during the gait movement. Obtaining the mean amplitude (渭 V), mean frequency (Hz), median frequency (Hz),) of the muscle measured by MyoResearch, a special signal processing software for Noraxon Company, USA SPPSS16.0 software was used to compare the difference of electromyography parameters between the affected side and the contralateral side by paired t test. [results] the results showed that 8 children with congenital equinovarus had their tibial anterior muscles in gait mode after Ponseti treatment. The mean amplitude of the surface electromyography of the medial head of gastrocnemius and the sural muscle of gastrocnemius was not significantly different from that of the contralateral, but had clinical significance. In addition, the average frequency of the surface myography of the affected tibial anterior muscle, the medial head of gastrocnemius and the sural muscle of the gastrocnemius was significantly higher than that of the contralateral (P0.05), and the median frequency of the surface myography of the anterior tibial muscle and the medial head of the gastrocnemius was higher than that of the contralateral side (P0.05). But there was no significant difference in median frequency of sural myoelectric activity. [conclusion] the function of bilateral leg muscle group in children with congenital horseshoe varus foot was evaluated by surface electromyography. It may provide an objective and reliable basis for judging the prognosis of children with congenital horseshoe varus after Ponseti treatment and when further surgical treatment is needed.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R726.8

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