不同方式引导肉毒毒素注射治疗脑卒中后屈腕屈指肌痉挛的效果比较

doi:10.3969/j.issn.1006-9771.2019.11.017

《中国康复理论与实践》 ›› 2019, Vol. 25 ›› Issue (11): 1352-1355.doi: 10.3969/j.issn.1006-9771.2019.11.017

不同方式引导肉毒毒素注射治疗脑卒中后屈腕屈指肌痉挛的效果比较

芦海涛^1,2, 崔利华³, 王艺铮¹

1.中国康复研究中心北京博爱医院神经康复中心，北京市 100068
2.首都医科大学康复医学院，北京市 100068
3.北京市丰台右安门医院康复医学科，北京市 100054

收稿日期:2019-07-10 修回日期:2019-08-01 出版日期:2019-11-25 发布日期:2019-11-21
通讯作者: 芦海涛，E-mail: 13051760807@163.com E-mail:13051760807@163.com
作者简介:芦海涛(1975-)，女，汉族，北京市人，博士，副主任医师，主要研究方向：神经康复。

Comparation of Effects of Botulinum Toxin Type A Injection under Different Guidance Approaches on Wrist and Finger Spasticity in Stroke Patients

LU Hai-tao^1,2, CUI Li-hua³, WANG Yi-zheng¹

1.Neurorehabilitation Center, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
2.Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
3.Physical Medicine & Rehabilitation Development, Beijing Fengtai You’anmen Hospital, Beijing 100054, China

Received:2019-07-10 Revised:2019-08-01 Published:2019-11-25 Online:2019-11-21
Contact: LU Hai-tao, E-mail: 13051760807@163.com E-mail:13051760807@163.com

摘要/Abstract

摘要： 目的观察肌电/电刺激和超声两种引导方式下注射肉毒毒素对脑卒中屈腕和屈指痉挛患者痉挛和运动功能的影响。方法回顾2015年1月至2019年5月脑卒中后屈腕及屈指痉挛并注射A型肉毒毒素治疗的患者，根据引导方式分为肌电/电刺激引导组(n = 36)和超声引导组(n = 37)，治疗前后采用改良Ashworth量表(MAS)和Fugl-Meyer评定量表(FMA)中腕和手指部分进行评定。结果治疗4周后，两组MAS和FMA评分均显著改善(|Z| > 4.654, P < 0.001)；超声引导组MAS评分优于肌电/电刺激引导组(|Z| > 1.980, P < 0.05)；超声引导组药物用量显著低于肌电/电刺激引导组(t = 4.023, P < 0.001)。结论超声引导下注射肉毒毒素改善脑卒中后腕指屈肌痉挛优于肌电/电刺激引导。

关键词: 脑卒中, 痉挛, 超声, 肌电图, 电刺激, 肉毒毒素

Abstract: Objective To compare the effects of Botulinum toxin type A (BTX-A) injection guided with electromyographic/electric stimulation or ultrasonography in patients with post-stroke spasticity of wrist and finger flexor muscles. Methods Inpatients with post-stroke spasticity of wrist and finger flexor muscles accepted BTX-A injection from January, 2015 to May, 2019 were reviewed. They were divided into electromyographic/electric stimulation-guided group (n = 36) and ultrasound-guided group (n = 37). They were assessed with modified Ashworth Scale (MAS) and Fugl-Meyer Assessment (FMA) before injection and four weeks after treatment. Results The scores of both MAS and FMA improved in both groups after treatment (|Z| > 4.654, P < 0.001), and the scores of MAS improved more in the ultrasound-guided group (|Z| > 1.980, P < 0.05), with less dosage of BTX-A (t = 4.023, P < 0.001). Conclusion Ultrasound-guided injection of BTX-A is more effective on wrist and finger flexion muscles spasticity than electromyographic/electric stimulation-guided method in stroke patients.

Key words: stroke, spasticity, ultrasonography, electromyography, electric stimulation, Botulinum toxin

中图分类号:

R743.3

芦海涛, 崔利华, 王艺铮. 不同方式引导肉毒毒素注射治疗脑卒中后屈腕屈指肌痉挛的效果比较[J]. 《中国康复理论与实践》, 2019, 25(11): 1352-1355.

LU Hai-tao, CUI Li-hua, WANG Yi-zheng. Comparation of Effects of Botulinum Toxin Type A Injection under Different Guidance Approaches on Wrist and Finger Spasticity in Stroke Patients[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2019, 25(11): 1352-1355.

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不同方式引导肉毒毒素注射治疗脑卒中后屈腕屈指肌痉挛的效果比较

Comparation of Effects of Botulinum Toxin Type A Injection under Different Guidance Approaches on Wrist and Finger Spasticity in Stroke Patients

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