上肢经肱骨截肢神经功能重建研究

表面肌电信号是一种安全、非侵入的电生理信息，作为实现直觉控制多功能肌电假肢系统的信息源而被广泛应用。由于经肱骨截肢者截肢的程度较高，残留的肢体肌肉少，缺乏足够的肌电信息源，无法实现多功能肌电假肢的直觉控制。目前现有技术是通过采用靶向肌肉神经功能重建的方法重建缺失肌电信息源。但目前国内尚未有关于截肢者残端神经功能重建方法的相关研究。因此，文章提出一种新型的神经吻合技术——目标神经功能替代术：采用靶向肌肉神经功能重建术与目标神经功能替代术相结合的方法，首次在国内对经肱骨截肢者成功实施了神经功能重建手术，成功建立了经肱骨截肢者神经功能重建模型，重建了因截肢而丧失的肌电信息。并采用高密度肌电技术对术前和术后的手-腕-肘部动作进行肌电信号采集，通过动作分类识别的准确率验证了该手术后肌电信息源重建的可靠性。这些结果初步验证了该方法可以为经肱骨截肢者残肢重建缺失肢体神经功能，并为直觉控制多功能肌电假肢提供潜在的信息源。

A Pilot Study of Nerve Function Reinnervation on a Transhumeral Amputee

Surface electromyography (sEMG) is a safe and non-invasive electrophysiological signal that has been widely used to provide intuitive control for myoelectric prostheses. Intuitively controlling a prosthetic device is a major challenge for transhumeral amputees (TAs) since they have insufficient residual muscles that could rarely produce enough sEMG signals. To resolve this challenge, targeted muscle reinnervation (TMR) technique which reinnervates the missing muscular has been developed in some previous studies. However, there is no relevant research on the reconstruction of nerve function for TAs in China. In this study, a new surgical method that integrates the TMR technique with targeted nerve function replacement (TNFR) for nerve function regeneration is presented, which is a pioneer study on the reconstruction of nerve function for TA in China. During the surgery, a nerve function model was established while the missing limb muscles were reconstructed for a male TA. To verify the reliability of the reconstructed limb muscles, the high density sEMG technique was used to acquire myoelectric signals corresponding to hand/wrist/elbow movements before and after the surgery. The classification accuracy across all the classes of limb motions were computed and analysed. The results show that the reconstructed muslces play a significant role in providing useful myoelectric control signals for efficiently decoding the different limb motions of the TA. The proposed hybrid (TMR-TNFR) method may be helpful in the reconstruction of the muscle function in residual limb of TAs, and could provide potential information for intuitive control of the myoelectric prostheses.