A型肉毒毒素治疗痉挛型脑性瘫痪的疗效2年随访

doi:10.3969/j.issn.1006-9771.2017.07.017

《中国康复理论与实践》 ›› 2017, Vol. 23 ›› Issue (7): 816-819.doi: 10.3969/j.issn.1006-9771.2017.07.017

A型肉毒毒素治疗痉挛型脑性瘫痪的疗效2年随访

刘建军, 齐婧, 张雁, 曾凡勇, 李南玲, 席冰玉, 吴卫红

1.首都医科大学康复医学院,北京市 100068;
2.中国康复研究中心北京博爱医院,北京市 100068

收稿日期:2016-10-31 出版日期:2017-07-25 发布日期:2017-08-07
作者简介:刘建军(1969-),男,汉族,北京市人,博士,主任医师,教授,硕士研究生导师,主要研究方向：儿童脑瘫、脑外伤、脑炎后遗症的康复治疗。E-mail: ljj990@163.com。

Effect of Botulinum Toxin Type A on Spastic Cerebral Palsy: Two Years Follow-up

LIU Jian-jun, QI Jing, ZHANG Yan, ZENG Fan-yong, LI Nan-ling, XI Bing-yu, WU Wei-hong

1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China;
2. Beijing Bo'ai Hospital, China Rehabilitation Research Centre, Beijing 100068, China

Received:2016-10-31 Published:2017-07-25 Online:2017-08-07
Contact: Correspondence to LIU Jian-jun. E-mail: ljj990@163.com

摘要/Abstract

摘要： 目的探讨A型肉毒毒素(BTX-A)阻滞术缓解脑瘫患儿痉挛的长期疗效。方法2005年6月至2013年12月,51例痉挛型脑瘫患儿按治疗方案分为两组,对照组(n=27)接受常规康复,试验组(n=24)在常规康复基础上接受BTX-A阻滞术治疗。治疗前采用改良Ashworth量表(MAS)、医师用评价量表(PRS)运动功能部分、粗大运动功能测量(GMFM) D区和E区进行评价;治疗2年后,采用PRS、GMFM进行评价。结果治疗前,两组患儿年龄,体质量,及术前MAS、PRS、GMFM均无显著性差异(t<1.207, χ²=0.076, P>0.05)。2年后复诊时,两组患儿PRS、GMFM较治疗前提高(t>2.217, P<0.05),试验组优于对照组(t>2.095, P<0.05)。结论BTX-A阻滞术长期疗效肯定。阻滞术后开展康复训练,有助于患儿运动功能提高。

关键词: 脑性瘫痪, 痉挛, 神经阻滞, A型肉毒毒素, 随访

Abstract: ObjectiveTo investigate the long-term effect of Botulinum toxin type A (BTX-A) block on spasticity in cerebral palsy. MethodsFrom June, 2005 to December, 2013, 51 children with spastic cerebral palsy accepted routine rehabilitation with (trial group, n=24) or without (control group, n=27) BTX-A block. They were assessed with modified Ashworth Scale (MAS), Physician Rating Scale (PRS) and Gross Motor Function Measure (GMFM) before treatment, and with PRS and GMFM two years after treatment. ResultsThere was no significant difference between two groups in ages, body mass, and scores of MAS, PRS and GMFM before treatment (t<1.207, χ²=0.076, P>0.05). The scores of PRS and GMFM improved in both groups two years after treatment (t>2.217, P<0.05), and improved more in the trial group than in the control group (t>2.095, P<0.05). ConclusionThe long-term effect of BTX-A block is positive. The rehabilitation training after block can promote their motor function recovery.

Key words: cerebral palsy, spasticity, nerve block, Botilinum toxin type A, follow-up

中图分类号:

R742.3

刘建军, 齐婧, 张雁, 曾凡勇, 李南玲, 席冰玉, 吴卫红. A型肉毒毒素治疗痉挛型脑性瘫痪的疗效2年随访[J]. 《中国康复理论与实践》, 2017, 23(7): 816-819.

LIU Jian-jun, QI Jing, ZHANG Yan, ZENG Fan-yong, LI Nan-ling, XI Bing-yu, WU Wei-hong. Effect of Botulinum Toxin Type A on Spastic Cerebral Palsy: Two Years Follow-up[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2017, 23(7): 816-819.

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A型肉毒毒素治疗痉挛型脑性瘫痪的疗效2年随访

Effect of Botulinum Toxin Type A on Spastic Cerebral Palsy: Two Years Follow-up

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