首都医科大学学报 ›› 2015, Vol. 36 ›› Issue (5): 805-808.doi: 10.3969/j.issn.1006-7795.2015.05.028

• 转化医学研究 • 上一篇    下一篇

电学治疗在脊髓损伤领域从基础研究转化为临床技术的研究进展

吕振, 姜树东, 白金柱, 张军卫, 王方永, 洪毅   

  1. 中国康复研究中心北京博爱医院脊柱外科 首都医科大学骨外科学系, 北京 100068
  • 收稿日期:2013-12-23 出版日期:2015-10-21 发布日期:2015-10-20

Translational study of electrical therapy for spinal cord injury from basic research to clinical technology

Lyu Zhen, Jiang Shudong, Bai Jinzhu, Zhang Junwei, Wang Fangyong, Hong Yi   

  1. Department of Spine Surgery, Beijing Bo, ai Hospital, China Rehabilitation Research Center, Department of Orthopedic Surgery, Capital Medical University, Beijing 100068, China
  • Received:2013-12-23 Online:2015-10-21 Published:2015-10-20
  • Contact: 洪毅 E-mail:hongyihhyy@163.com

摘要: 目的 通过总结多种电学方法在脊髓损伤领域中的临床疗效,讨论电学技术从基础研究转化为临床技术的研究进展,为今后临床工作的开展提供转化医学的新思路。方法 分析电学治疗方法的起源及发展过程,讨论并分析4种电学技术转化为脊髓损伤领域治疗技术的临床疗效,这些技术包括:脊髓损伤部位的电刺激技术,瘫痪肢体的功能性电刺激技术,呼吸功能障碍的膈肌起搏技术和排尿功能障碍的神经电调节技术。结果 1)直流电场能够促进未完全断裂的脊髓轴突再生,振荡电场能够双向修复脊髓损伤近端和远端的神经轴突。2)功能性电刺激用于重建瘫痪肢体的运动功能,通过刺激肢体周围神经引起肌肉按照一定顺序收缩产生动作,可以预防多种合并症。3)膈肌起搏技术能够诱发膈肌收缩,保证脊髓损伤膈肌功能障碍患者呼吸时产生自然的负压状态,重建呼吸功能。4)频率为5~20 Hz,脉宽为1~5 ms的电流能够既抑制逼尿肌的过度活动,又改善诸多盆底功能。结论 电流作为一种治疗技术,既有作为生物电的共性,又在不同条件下具备不同的电学特性和临床疗效。今后的脊髓损伤研究中,应加强电学治疗技术与临床技术的结合,来解决更多的临床问题。

关键词: 转化医学, 脊髓损伤, 电学治疗

Abstract: Objective Electrical therapy is an important treatment in the clinical spinal cord injury. It provides an effective modality to improve the various dysfunction after spinal cord injury (SCI). Methods Four kinds of electrical technologies were reviewed. They are electrical stimulation on spinal cord injury site, functional electrical stimulation on the paralysis of limbs, diaphragm pacing on respiratory insufficiency and neural modulation on voiding dysfunction. Results (1)DC electric field could promote untransected axonal regeneration, and the oscillating electric field can promote two-way repair of the cranial and caudal spinal axons. (2)Functional electrical stimulation, used to reconstruct the neuromuscular function, stimulate the muscle of the limb, causing muscle contraction and limb motion, thus complete the extension of elbow, grasping, standing, walking and other motor function, and prevent complications.(3)Diaphragm pacing can induce diaphragm muscle contraction, to maintain the natural negative pressure breathing in patients with diaphragmatic dysfunction.(4)The electric frequency of 5-20 Hz and pulse width 1-5 ms can both effectively inhibit detrusor contraction and improve pelvic functions. Conclusion Electric therapy as a treatment technology, shows not only the similar effects as bioelectricity, but also various characteristics under different electrical conditions. In future research, the combination of electrical treatment technology and other technology should be strengthened, so as to solve more clinical problems.

Key words: translational medicine, spinal cord injury, electrical treatment

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