《中国康复理论与实践》

《中国康复理论与实践》 ›› 2011, Vol. 17 ›› Issue (5): 449-451.

• 论文 • 上一篇    下一篇

重复注射A型肉毒毒素对脑卒中后下肢痉挛状态的影响1

陈奕雄，倪莹莹，邱承尧，张芸，黎肖弟，刘云义，陈星，赖喜新，冯重睿，张婷婷   

  1. ：广东三九脑科医院，广东广州市 510510。
  • 收稿日期:2010-09-02 修回日期:2010-11-26 出版日期:2011-05-25 发布日期:2011-05-25

Repeated Injection of Botulinum Toxin Type A for Lower Limb Spasticity after Stroke

CHEN Yi-xiong, NI Ying-ying, QIU Cheng-yao, et al.   

  1. Guangdong 999 Brain Hospital, Guangzhou 510510, Guangdong, China
  • Received:2010-09-02 Revised:2010-11-26 Published:2011-05-25 Online:2011-05-25

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摘要： 目的观察脑卒中后下肢肌肉痉挛患者重复给予A型肉毒毒素(BTX-A)的治疗效果。方法选择180 例脑卒中后下肢肌肉痉挛患者，治疗组90 例采用BTX-A重复2 次进行局部肌肉注射，注射间隔3~6 个月。对照组90 例只给予康复治疗。在每次注射前，注射后3 d、7 d、1 个月、3 个月分别用改良Ashworth 量表(MAS)、Fugl-Meyer 下肢运动评测、Berg 平衡量表(BBS)、修订的Barthel 指数(MBI)进行评定；对照组在康复相同时间后进行评定。结果治疗组两次注射后分别与治疗前相比较，痉挛肌肉MAS评分、Fugl-Meyer 评分、BBS 评分、MBI 评分均有显著性差异(P<0.05)，7 d 及1 个月Fugl-Meyer 评分、BBS 评分、MBI 评分有非常显著性差异(P<0.01)；第2 次注射后与第1 次注射后比较，各项评分均无显著性差异(P<0.05)。治疗组2 次注射后分别与对照组比较，各项评分均有非常显著性差异(P<0.01)。结论重复局部肌肉注射BTX-A治疗脑卒中后下肢肌痉挛患者疗效显著。

关键词: 脑卒中, 痉挛, 下肢, A型肉毒毒素, 重复注射

Abstract: Objective To observe the effects of repeated Botulinum toxin type A (BTX-A) injection on lower limb spasticity after stroke.Methods 180 cases with lower limb spasticity after stroke were divided into the treatment group (n=90) and the control group (n=90). The treatment group was treated with BTX-A injection twice in the spastic muscles at interval of 3~6 months, while both the treatment group and the control group accepted the rehabilitation based on the neurodevelopmental therapy. They were assessed with modified Ashworth Scale (MAS), Fugl-Meyer Lower Limb Assessment (FMAL), Berg Balance Scale (BBS), modified Barthel Index (MBI) before each injection, and 3 d, 7 d, 1 month, 3 months after each injection or the same time for the controls. Results There was significant difference in scores of MAS, FMAL, BBS, MBI for the treatment group among before and 3 d, 7 d, 1 month after each injection (P<0.05), but not significant between 2 injections (P<0.05). There was significant difference in scores of all the assessment between the treatment and control group at the same time (P<0.01). Conclusion Repeated intramuscular injection of BTX-A can reduce the spasticity of lower limb after stroke.

Key words: stroke, spasticity, lower limb, Botulinum toxin type A, repeated injection