CAJ | 학술논문

目的评价超声引导联合体表定位技术注射肉毒毒素治疗脑卒中后肌痉挛的效果.方法选择2009年1月至2011年1月在中山大学附属第三医院住院的脑卒中下肢痉挛患者18例,在超声引导联合体表定位技术引导下,将BTXA准确注入靶肌.注射后进行常规康复训练.在注射前、注射后3d、1、2、4及12周时,分别采用改良Ashworth评分、踝关节被动活动度测量、10 m步行测试、Berg平衡量表进行相关评价.结果治疗组在注射后1、2、4及12周,肌张力[治疗前(2.6±0.5)分,治疗后12周(1.05 ±0.29)分]、踝关节被动活动度[治疗前(7.2±2.4)°,治疗后12周(18.6±2.2)°]、10 m步行时问[治疗前(55 ±5)s,治疗后12周(43±4)s]、Berg平衡量表评分[治疗前(34.7±5.1)分,治疗后12周(45.8±2.1)分]均较注射前明显改善(P＜0.05).结论采用超声引导联合体表定位的肉毒毒素注射技术治疗脑卒中后肌痉挛,定位准确,治疗效果显著.
목적 평개초성인도연합체표정위기술주사육독독소치료뇌졸중후기경련적효과.방법 선택2009년1월지2011년1월재중산대학부속제삼의원주원적뇌졸중하지경련환자18례,재초성인도연합체표정위기술인도하,장BTXA준학주입파기.주사후진행상규강복훈련.재주사전、주사후3d、1、2、4급12주시,분별채용개량Ashworth평분、과관절피동활동도측량、10 m보행측시、Berg평형량표진행상관평개.결과 치료조재주사후1、2、4급12주,기장력[치료전(2.6±0.5)분,치료후12주(1.05 ±0.29)분]、과관절피동활동도[치료전(7.2±2.4)°,치료후12주(18.6±2.2)°]、10 m보행시문[치료전(55 ±5)s,치료후12주(43±4)s]、Berg평형량표평분[치료전(34.7±5.1)분,치료후12주(45.8±2.1)분]균교주사전명현개선(P＜0.05).결론 채용초성인도연합체표정위적육독독소주사기술치료뇌졸중후기경련,정위준학,치료효과현저.
Objective To evaluate the clinical efficacies of botulinum toxin type A ( BTX-A ) injection under ultrasonic guidance and body surface positioning in poststroke patients with lower extremities spasticity.Methods From January 2009 to January 2011,a total of 18 patients with stroke-related spasticity in lower extremities were recruited at Third Affiliated Hospital of Sun Yat-sen University.Under the guide of color Doppler ultrasound and body surface positioning,BTX-A was injected into multi-points of muscles.The outcome after BTX-A injection was assessed by modified Ashworth scale ( MAS ),passive range of movement ( PROM),10-meter walking test ( 10 MWT) and Berg balance scale (BBS).Assessments were performed at baseline,Day 3,Weeks 1,2,4 and 12 post-injection respectively.Results Compared the scores of MAS ( MASpre-treatment 2.6 ± 0.5,MASpre-treatment 1.9 ± 0.2 - 1.1 ± 0.3 score),PROM ( PROMpre-treatment 7.2 ± 2.4～,PROMpost-treatment 12.3 ±2.0- 18.6 ± 2.2°) between baseline and follow-up at Weeks 1,2,4 and 12 postt reatment,there were significant statistical differences (P ＜ 0.05 ).10 MW (10 MWTpre-treatment 55.1 ± 5.2 s,10 MWTpre-treatment 48.6 ±4.2 42.9 ±3.8 s) and BBS (BBSpre-treatment 34.7 ±5.1,BBSpre-treatment 39.9 ±4.9 -45.8 ± 2.1 score) improved greatly at Weeks 2,4 and 12 post-treatment.Conclusion Ultrasonic guidance and body surface positioning is an accurate positioning modality of using BTX-A for treating the spasticity of lower extremities.