| 赵宝珠,曲玉娟,宋沙沙,赵 秦,岳寿伟.调制中频电对脊髓损伤患者下肢深静脉血流动力学的影响[J].中国康复医学杂志,2020,(10):1187~1191 |
| 调制中频电对脊髓损伤患者下肢深静脉血流动力学的影响 点此下载全文 |
| 赵宝珠 曲玉娟 宋沙沙 赵 秦 岳寿伟 |
| 山东大学齐鲁医院康复科，山东省济南市，250012 |
| 基金项目： |
| DOI：10.3969/j.issn.1001-1242.2020.10.006 |
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| 摘要： |
| 摘要
目的：探究调制中频电对脊髓损伤患者下肢深静脉血流动力学的影响；比较调制中频电（modulated medium frequency current therapy，MMFCT）与间歇充气加压装置(intermittent pneumatic compression，IPC)在加速脊髓损伤患者下肢深静脉血流速度方面的作用差异。
方法：纳入20例健康受试者及20例脊髓损伤患者。健康受试者左侧下肢分别用4种不同调制处方的中频电治疗刺激腓肠肌，然后使用多普勒超声测量腘静脉的收缩期峰值血流速度（PSV）、平均血流速度，筛选血流加速效果最好的处方。利用筛选的处方刺激脊髓损伤患者腓肠肌，测量股静脉PSV、刺激期平均血流速度、每分钟射血量，对比间歇充气加压装置治疗时股静脉的上述指标。
结果：健康志愿者腘静脉基础PSV为9.5±3.3cm/s，基础平均血流速度为4.2±1.7cm/s，连续调制波刺激时腘静脉PSV加快了约250%，平均血流速度加快了200%。断续调制波相较于连续调制波，腘静脉PSV加快了约160%，平均血流速度加快了约140%，差异均有显著性意义（P<0.05）。不同波形治疗的效果没有显著性差异（P>0.05）。脊髓损伤患者静息时下肢股静脉基础峰值血流速度为6.5±2.7cm/s，基础平均血流速度为2.6±1.4cm/s，基础每分钟射血量为37.6±17.4ml/min。刺激时脊髓损伤患者股静脉的PSV、刺激期平均血流速度、单位时间射血量均明显升高，差异具有显著性意义（P<0.05）。间歇充气加压装置治疗时的PSV、刺激期平均血流速度优于MMFCT， 但MMFCT治疗时的单位时间射血量高于IPC，差异均具有显著性意义（P<0.05）。
结论：间歇调制波单次刺激加速血流的效果优于连续调制波，而不同波形之间治疗效果没有显著性差异。在脊髓损伤患者中，MMFCT能产生类似于IPC的加速下肢静脉血液回流的作用，推测其能用于下肢深静脉血栓的预防。IPC单次加速下肢静脉血流的效果优于MMFCT，但MMFCT治疗时的单位时间射血量高于IPC。 |
| 关键词：调制中频电治疗 收缩期峰值血流速度 深静脉血栓形成 间歇充气加压装置 |
| Effects of the modulated medium frequency current therapy on the leg deep vein haemodynamics in patients with spinal cord injury Download Fulltext |
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| Rehabilitation Department of Qilu Hospital of Shandong University，Jinan，250012 |
| Fund Project: |
| Abstract: |
| Abstract
Objective: (a)Assessing the effect of the modulated medium frequency current therapy(MMFCT) on the leg deep vein haemodynamics of patients with spinal cord injury. (b)Comparing the effect of the MMFCT and the Intermittent pneumatic compression(IPC) on leg deep vein blood velocity in patients with spinal cord injury.
Method：Twenty normal volunteers were recruited. The gastrocnemius muscle was stimulated by different MMFCT(4KHz carrier with either jagged or exponential 1Hz continuous modulation, and the same modulation with intermittent 1s stimulation and 1s blackout). For comparison, the leg was treated with IPC also. During the treatment, popliteal veins blood flow velocity were measured by ultrasound. Twenty patients with spinal cord injury were recruited then. Their gastrocnemius muscle were stimulated by intermittent MMFCT and treated with IPC also. The femoral veins blood flow were measured by ultrasound.
Result：The peak blood velocity of popliteal vein in normal volunteers at rest was 9.5±3.3cm/s and the average velocity was 4.2±1.7cm/s. the MMFCT resulted in quicker peak blood velocity（2.5 times) and average blood velocity(2times) than the baseline. The Intermittent modulation is superior to the continuous modulation. The MMFCT can also enhance the blood velocity of femoral vein in spinal cord injury patients. and it's effect is inferior to the Intermittent pneumatic compression is superior to MMFCT in accelerating the peak velocity and average blood velocity of femoral vein（P<0.05）, but less effect on the blood empty(ml/min)（P<0.05）
Conclusion:The modulated medium frequency current therapy can enhance the flow of the lower limbs. The capacity of enhancing of popliteal blood of the intermodulation is superior to the continuous modulation. It can also enhance the the flow of patients with spinal cord injury. The MMFCT is inferior to the Intermittent pneumatic compression in the capicity of enhancing of femoral vein blood velocity， but it can empty more blood in the same time than the IPC. |
| Keywords:modulated medium frequency current therapy peak systolic velocities deep venous thrombosis intermittent pneumatic compression |
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