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題名 | 腦中風患者患肢肩痛的肌電圖檢查= |
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作者 | 鄭寶釵; 李嘉恩; 廖美雲; 黃美涓; |
期刊 | 復健醫學會雜誌 |
出版日期 | 19940600 |
卷期 | 22:1 1994.06[民83.06] |
頁次 | 頁67-74 |
分類號 | 415.922 |
語文 | chi |
關鍵詞 | 腦中風; 患肢肩痛; 肌電檢查; Stroke; Hemiplegic shoulder pain; Electrophysiological study; |
中文摘要 | 本研究共收集了50例腦中風患者,他們均無糖尿病史,且以前無肩關節受傷或疼痛的病史。我們將其分為三組,A組包括肩手症候群(shoulder-hand syndrome)和視丘痛(thalamic pain)等自發性肩痛病例,B組包括被動肩關節活動時因牽扯引起疼痛的病例,C組則無肩痛的患者(作為對照組)。此三組分別依臨床上其他因素做比較,結果發現肩痛與肩關節脫垂及活動度受限有明顯的相關,而與患肢之運動機能、感覺機能及肌肉痙攣度未呈有意義的相關。患肢的正中神經運動傳導速度明顯的比健側者慢;而感覺神經傳導速度則患側與健側無統計學上有意義的差異。至於F波潛期,在A及B組有明顯的差異,在C組則無。肌電圖檢查發現A組有94%、B組71%及C組28%在短外展拇肌、外展小指肌及伸指總肌出現去神經肌電變化的肌纖維顫波(fibrillation)和正相尖波(positive sharp wave),顯示肌纖維顫波及正相尖波的出現與腦中風患者患肢肩痛有明顯相關,且與患肢運動機能較差者有關,但與感覺機能、肌肉痙攣度、肩關節脫垂、肩關節活動異常及患腦中風日數無明顯的相關。 |
英文摘要 | A total of 50 patients, who had developed hemiplegia or hemiparesis as a result of a cerebral vascular disease, were collected for electrophysiologic study. All of these patients were free of peripheral nerve disorder or shoulder joint pathology. MNCV, SNCV, F latencies of bil median nerves and concentric needle electromyographic examination were done. The relationship between electrophysiological findings and clinical features of the patients was analyzed. A positive correlation between shoulder pain and presence of should subluxation or shoulder ROM limitation was found. However, no significant correlation of shoulder paint to the severity of motor deficit, sensory impairment or spasticity of the hemiplegic side was found. The mean MNCV and F latency of median nerve were delayed, as compared with the contralateral normal arm (P<0.05), but no significant difference was found in SNCV. There was a negative correlation between spontaneous activities and muscle strength in the hemiplegic arm (P<0.025). However, the appearance of spontaneous activity showed no correlation to the severity of spasticity, sensory impairment and shoulder subluxation. Spontaneous EMG activity was observed in 94% of the stroke patients with shoulder hand syndrome or thalamic pain, whereas only in 28% of those stroke patients without shoulder pain (P<0.001). This findings strongly suggested that there is probably some relationship between the appearance of spontaneous EMG activities and shoulder pain on hemiplegic limbs. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。