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目的:利用功能核磁共振成像(f MRI)技术探究反馈式功能性电刺激对脑梗死患者上肢运动功能的影响,为脑梗死患者的康复提供最佳治疗方案。方法:选取2010年1月至2014年12月我院收治的脑梗死患者42例,随机分为I、II、III组,各14例,3组患者均接受常规康复治疗和药物治疗,在此基础上,I组行反馈式功能电刺激治疗,II组行单纯功能性电刺激治疗,疗程均为28天。治疗前后对所有患者进行上肢功能Fugl-Meyer运动量表评估和腕背屈关节活动度测量,并于治疗后3 d内对患者大脑M1区的激活强度进行f MRI检查。结果:3组患者的运动功能均较治疗前有所改善,其中Fugl-Meyer运动量表评分和腕背屈关节活动度的测量结果显示,I、II组测量结果明显好于III组,I组测量结果明显好于II组,差异具有统计学意义(P<0.05)。患者大脑M1区激活强度对比,I、II组明显强于III组(P<0.05),I组测量明显强于II组,差异均有统计学意义(P<0.05)。结论:脑梗死康复期患者采用功能性电刺激治疗有助于受损脑功能重组,其中反馈式功能性电刺激强调人的主观性运动,较单纯性电刺激效果更好。
Objective: To explore the influence of functional electrostimulation on the motor function of upper limbs in patients with cerebral infarction by functional magnetic resonance imaging (f MRI), so as to provide the best treatment for the patients with cerebral infarction. Methods: Forty-two patients with cerebral infarction admitted to our hospital from January 2010 to December 2014 were randomly divided into groups I, II and III, and 14 patients in each group. All patients in the three groups received routine rehabilitation and drug therapy. On the basis of Group I, the feedback function of electrical stimulation, Group II, simple functional electrical stimulation treatment, treatment were 28 days. Before and after treatment, all patients were evaluated for upper limb function Fugl-Meyer scale and carpal dorsiflexion joint mobility measurement. The intensity of M1 activation in the brain of patients was evaluated by f MRI within 3 days after treatment. Results: The motor function of the three groups improved compared with that before treatment. The measurement results of Fugl-Meyer motor scale and carpal dorsiflexion joint mobility showed that the measurement results of group I and II were significantly better than that of group III, and the measurement of group I The results were significantly better than the group II, the difference was statistically significant (P <0.05). The intensity of M1 activation in the brain of patients was significantly higher than those in group I and II (P <0.05). The intensity of group I was significantly stronger than that of group II (P <0.05). CONCLUSIONS: Functional electrical stimulation in convalescent patients with cerebral infarction may contribute to impaired brain functional remodeling. Among them, feedback functional electrical stimulation emphasizes subjective movement, which is better than pure electrical stimulation.