目的 观察肌电诱发神经肌肉电刺激对改善早期脑卒中偏瘫患者肢体运动功能的临床疗效.方法 发病4周内、不能主动完成腕背伸运动,且患侧腕背伸时所测收缩肌电值=基础肌电值的患者60例,分为2组:对照组(n=30)应用神经肌肉电刺激疗法,治疗组(n=30)应用肌电诱发的神经肌肉电刺激疗法,共治疗4周.治疗前后测定患者静态及收缩时肌电值,应用简式Fugl-Meyer运动功能评定(FMA)、Barthel指数对患者进行评定.结果 两组患者治疗后的肌肉静态及收缩时肌电值、FMA评分、Barthel指数评分均有显著改善(P=0.000),治疗组比对照组改善更多(P＜0.05).结论 肌电诱发的神经肌肉电刺激疗法即使于发病早期,未检测到肌肉收缩肌电值变化的情况下也可以用于偏瘫患者上肢瘫痪肌肉的功能治疗,其疗效优于神经肌肉电刺激疗法.%Objective To study the effects of electromyography-triggered neuromuscular stimulation on upper extremity functional recovery of acute stroke patients. Methods 60 stroke patients who lost wrist extension even in the electromyography (EMG) within 4 weeks were randomly assigned to experimental group and control group. The experimental group received electromyography-triggered neuromuscular stimulation, and the control group received neuromuscular stimulation. They were assessed with EMG, Fugl-Meyer assessment (FMA), Barthel index (BI) before and 4 weeks after treatment. Results The EMG, scores of FMA and BI improved in all the patients after treatment (P=0.000), and improved more in the experimental group (P<0.05). Conclusion Electromyography-triggered neuromuscular stimulation can improve the motor function of hemiplegia, even in the patients without change of EMG.
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