【作者】 王国庆；

【导师】 谢丰；

【作者基本信息】 上海交通大学 ， 儿科学（专业学位）， 2015， 硕士

【摘要】 【目的】先天性马蹄内翻足(congenital clubfoot,CCF)是儿童最常见的先天性四肢畸形之一,病因尚不清楚。本研究旨在探讨表面肌电检测技术在Ponseti治疗后先天性马蹄内翻足患儿中的临床意义。【方法】本研究采用十六通道表面肌电图遥测仪对Ponseti治疗后的8名单侧先天性马蹄内翻足患儿进行表面肌电检测,所有患儿均可自主平地行走9 m,在步态行进过程中同时测量患侧与对侧小腿胫前肌、腓肠肌内侧头、腓骨肌的表面肌电信号,利用美国Noraxon公司专用信号处理软件MyoResearch获得所测肌肉的平均振幅(μV)、平均频率(Hz)、中位频率(Hz),采用SPPSS16.0统计软件利用配对t检验分别比较患侧和对侧各表面肌电参数的差异。【结果】结果发现8名Ponseti治疗后的单侧先天性马蹄内翻足患儿在步态模式下其患侧胫前肌、腓肠肌内侧头和腓骨肌表面肌电图的平均振幅较对侧虽无明显统计学差异但具有临床意义。另外,8名患儿患侧胫前肌、腓肠肌内侧头、腓骨肌表面肌电的平均频率明显高于对侧(P<0.05),患侧胫前肌和腓肠肌内侧头表面肌电的中位频率高位对侧(P<0.05),而腓骨肌表面肌电的中位数频率无明显统计学差异。【结论】利用表面肌电检测技术对先天性马蹄内翻足患儿双侧小腿肌群的功能进行评估,可能为判断Ponseti治疗后先天性马蹄内翻足患儿的预后及何时需进一步手术治疗提供客观、可靠的依据。更多还原

【Abstract】 ObjectivesCongenital clubfoot is one of the most common deformity in children’s skeletal-muscular system.The etiology is unknown but it is closely related to neuromuscular abnormalities. This article aims to observe and analyze the surface electromyography activity of the lower limb muscles of the patients with congenital clubfoot treated by the Ponseti’s method during independent gait. MethodsIn current study, 8 unilateral congenital clubfoot children were included by walking on the flat land with sEMG monitor.All the children can walk 9m independently.Lower limb muscles(Tibialis anterior muscle,Media head of gastrocnemius muscle,peroneal muscle)of these children were tested by surface electromyography(NORAXON TELEMYO 2400 R G2,USA).The different parameters(Mean amplitude,Mean frequency;Median frequency)between the affected limb and the contralateral side were analyzed. SPSS16.0 statistical software package was used for the study and collection of data using compare samples t-test analysis and processing. ResultsThe results showed that while the congenital clubfoot children treated by the Ponseti’s method were walking independently on flat ground,the mean amplitude of affected leg weren’t lower than the contralateral side;the mean frequency and median frequency of the affected limb were higher than the contralateral side(P<0.05). To our knowledge, this is the first research of the SEMG of peroneal muscles activity on the neuromuscular etiology and prognosis of clubfoot.Type I muscle fibers increased obviously in both tibialis anterior muscle and media head of gastrocnemius. ConclusionsUseing surface electromyography to exam the evertor muscle(peroneal muscle) function of the clubfoot may be considered as an objective and reliable indicator of the etiology correlated with the neuromuscular abnormalities and prognosis of the clubfoot treated with Ponseti’s method.更多还原