《中国康复理论与实践》

《中国康复理论与实践》 ›› 2011, Vol. 17 ›› Issue (7): 654-656.

• 论文 • 上一篇    下一篇

康复训练对A型肉毒毒素治疗痉挛型脑瘫长期疗效的影响

刘建军，纪树荣，吴卫红，张雁，曾凡勇，李南玲   

  1. 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儿童康复科，北京市 100068。
  • 收稿日期:2011-04-01 修回日期:1900-01-01 出版日期:2011-07-25 发布日期:2011-07-25

Effect of Rehabilitation on Long-term Efficacy of Botulinum Toxin Type A on Spastic Cerebral Palsy

LIU Jian-jun, JI Shu-rong, WU Wei-hong, et al.   

  1. Capital Medical University School of Rehabilitation Medicine, Beijing Charity Hospital, China Rehabilitation Research Centre, Beijing 100068, China
  • Received:2011-04-01 Revised:1900-01-01 Published:2011-07-25 Online:2011-07-25

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摘要： 目的探讨康复训练对A型肉毒毒素(BTX-A)阻滞术缓解脑瘫患儿痉挛长期疗效的影响。方法230 例痉挛型脑瘫患儿接受BTX-A阻滞术治疗，根据患儿体重和修改的Ashworth 量表(MAS)评分确定BTX-A剂量。A组每天进行康复训练2 h 以上，B组进行康复训练2 h 以下或无训练。1 年后评定其粗大运动功能(GMFM)。结果A、B两组患儿的年龄、体重、术前的MAS、GMFM均无显著性差异(P>0.05)，两组患儿肉毒毒素作用时间无显著性差异(P>0.05)。术后1 年两组GMFM均较术前提高(P<0.05)。A组GMFM分数提高明显多于B 组(P<0.01)。结论BTX-A阻滞术后有肯定的长期疗效。阻滞术后开展康复训练有助于患儿粗大运动功能的提高。

关键词: 脑性瘫痪, 痉挛, A型肉毒毒素, 长期疗效, 神经阻滞, 康复

Abstract: Objective To investigate the long-term efficacy of Botulinum toxin type A (BTX-A) on spasticity in cerebral palsy, and theeffect of rehabilitation on it. Methods 230 children with spastic cerebral palsy were treated with BTX-A block. The dose of BTX-A wasidentified with the weight of the children and the Modified Ashworth Scale (MAS). They were divided into group A who exercised morethan 2 h/d, and group B who exercised less than 2 h/d or not. They were assessed with Gross Motor Function Measure (GMFM) 1 year aftertreatment. Results There was no significant difference between group A and B with ages, weight, MAS, GMFM before block (P>0.05), norwith BTX-A effect time (P>0.05). The GMFM improved significantly in both group A and B 1 year after block (P<0.05), and it improvedmore in group A than group B (P<0.01). Conclusion The long-term efficacy of BTX-A block is positive. The rehabilitation training afterblock can help children to improve their gross motor function.

Key words: cerebral palsy, spasticity, Botulinum toxin type A, long-term efficacy, nerve block, rehabilitation