摘要
目的了解膈肌各位点运动诱发电位(motor evoked potential)的特点,从而寻求检测膈肌MEP的最佳位点。方法健康雄性SD大鼠30只,体重250～270 g。采用Reporter型肌电图仪给予单个方波电脉冲刺激,刺激强度15 mA,波宽0.2 ms,刺激间隔200 ms。直视下,将同心圆针电极分别插入膈肌内侧脚、中间脚、外侧脚、腋后线第11肋骨下缘、腋前线第9肋骨下缘、锁骨中线第8肋骨下缘、胸骨旁线第7肋骨下缘、胸骨部。记录信号经放大后,打印保存以备后续分析。结果30只SD大鼠经颅电刺激后每侧膈肌8个位点均可记录到双相诱发电位。各位点潜伏期变化不大,为(2.95±0.21)ms。各位点各自波幅相对恒定。但各位点间波幅变化较大,胸骨部最小,为(0.97±0.05)mV。腋前线第9肋骨下缘最大,为(6.08±0.46) mV。同时发现,从腋前线第9肋骨下缘进针时,此处离胸膜返折部有一定的距离,在针通过腹外斜肌、腹内斜肌及肋间肌后可安全到达膈肌,而不会穿透胸膜伤及肺。结论以腋前线第9肋骨下缘为进针点,垂直胸壁进针行膈肌MEP监测操作方便、安全、可靠。该处波幅最大,是监测膈肌MEP较理想的位置。
Objective To study the characteristics of the transcranial electric stimulation （TES）-elicited motor evoked potentials（MEP） recorded from different points of the diaphragm, and to determine the optimal recording site in the diaphragm. Methods One EEG electrode was placed subcutaneously in the midline of the skull as stimulation electrode and another EEG electrode was inserted into hard palate submucously as cathode in 30 male rats. And single square wave electrical pulse was used for stimulation. The stimulation intensity was 15 mA, the duration of the pulse was 0.2 ms, and the stimulating interval was 200 ms. The concentric needle electrode were inserted into the following eight sites： the medial, intermediate, lateral crura of the diaphragm,the junction of the posterior axilla line and the inferior border of the eleventh rib, the junction of the anterior axilla line and the inferior border of the ninth rib, the junction of the intermediate line of the clavicle and the inferior border of the eighth rib, the junction of the para-sternal line and the inferior border of the seventh rib, the pars sternalis. The MEP was recorded from each point, respectively. The optimal sites of the diaphragm MEP were found and recorded. Results The MEPs were recorded from each of the 8 sites of the diaphragm in all the rats after TES. There was no statistically significant difference among the latencies of every site. But the amplitude varied from 6.08± 0.46 mV in maximum along the inferior border of the ninth rib at the anterior line of the axilla to the minimum of 0.91 ± 0.03 mV at the pars sternalis. Conclusion It is safer to insert the needle along the inferior border of the ninth rib at the anterior line of the axilla, because there was certain distant from the folding part of the pleura and the amplitude of the recorded wave at this point is maximal.
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2007年第8期534-536,共3页
Chinese Journal of Physical Medicine and Rehabilitation
基金
国家自然科学基金(30571886)
关键词
膈肌
运动诱发电位
电刺激
Diaphragm
Motor evoked potentials
Electric stimulation
