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。
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.
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