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[通过组织内电刺激实现周围神经功能恢复]

[Peripheral nerves' function recovery by intratissual electric stimulation].

作者信息

Gerasimov A A, Burmatov N A, Kopylov S A

机构信息

Ural State Medical University, Ekaterinburg, Russia.

Tyumen State Medical University, Tyumen, Russia.

出版信息

Vopr Kurortol Fizioter Lech Fiz Kult. 2024;102(4):36-44. doi: 10.17116/kurort202410104136.

Abstract

UNLABELLED

An intratissual electrical stimulation, accompanied by irritation of their central neurons, is used to recover the function of damaged peripheral nerves. Treatment results exceeded those with the use of cutaneous electrical stimulation, which is confirmed by comparative results of trial animal experiments. The time and quality of peripheral nerves' function recovery in comparison of intratissual and cutaneous electrical stimulation methods remain unknown.

OBJECTIVE

To evaluate the time and quality of peripheral nerves' functions recovery after their suturing and conducting two different methods of electrical stimulation, namely intratissual and cutaneous, in projection of central neurons of damaged spinal nerves in the postoperative period.

MATERIAL AND METHODS

The basic technical parameters of the method of peripheral nerves' functions recovery in the postoperative period were ptacticed. Postoperative rehabilitation treatment was performed in 77 patients with traumatic peripheral nerves' injuries at the level of the forearm: in 42 with intratissual electrical stimulation, in 35 - using cutaneous one with similar characteristics of electrical current and concomitant pharmacological therapy. The follow-up duration was 2 years.

RESULTS

A significant (in 4-6 times) reduction in time of treatment and a greater improvement in qualitative indicators when using intratissual electrical stimulation compared to the use of cutaneous stimulation were obtained. The effectiveness of the restorative therapy was dependent on the number of procedures, and a complete recovery of the damaged peripheral nerves' functions was observed after three courses of intratissual electrical stimulation.

CONCLUSION

The time and degree of recovery of peripheral nerves' functions depends on the functional activity of their central neurons at the level of the spinal cord. The activation of these neurons by low-frequency electrical current allows to activate their trophic function. Thus, the cutaneous electrical stimulation does not cause the necessary level of irritation of the neurons due to the fact that the skin is a barrier to electrical current, which reduces its impact in 200-500 times. The intratissual electrical stimulation allows to solve the problem by supplying the needle-electrode much closer to the «target». The proposed method of intratissual electrical stimulation has shown its advantage over cutaneous electrical stimulation, significantly reducing the duration of the restorative treatment and increasing its qualitative indicators.

摘要

未标注

组织内电刺激,伴随对其中枢神经元的刺激,用于恢复受损外周神经的功能。治疗结果超过了使用皮肤电刺激的结果,这在试验动物实验的对比结果中得到了证实。与皮肤电刺激相比,组织内电刺激方法中外周神经功能恢复的时间和质量尚不清楚。

目的

评估在术后阶段,对受损脊神经中枢神经元进行投射时,外周神经缝合并采用两种不同电刺激方法(即组织内和皮肤)后功能恢复的时间和质量。

材料与方法

实践了术后外周神经功能恢复方法的基本技术参数。对77例前臂水平创伤性外周神经损伤患者进行术后康复治疗:42例采用组织内电刺激,35例采用具有相似电流特征的皮肤电刺激并辅以药物治疗。随访时间为2年。

结果

与皮肤刺激相比,使用组织内电刺激时治疗时间显著缩短(4至6倍),质量指标有更大改善。恢复治疗的效果取决于治疗次数,在进行三个疗程的组织内电刺激后观察到受损外周神经功能完全恢复。

结论

外周神经功能恢复的时间和程度取决于脊髓水平其中枢神经元的功能活动。低频电流对这些神经元的激活可使其营养功能得以激活。因此,皮肤电刺激由于皮肤是电流的屏障,不会引起神经元所需的刺激水平,这使其影响降低200至500倍。组织内电刺激通过将针电极更靠近“靶点”来解决这一问题。所提出的组织内电刺激方法已显示出优于皮肤电刺激的优势,显著缩短了恢复治疗的持续时间并提高了其质量指标。

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