CAJ | 학술논문

目的观察并比较脑瘫患者实施选择性脊神经后根切断术(SPR)和神经根部分切断并逆行交叉吻合术(SPA)的疗效.方法广东省第二人民医院和解放军第88医院全军骨科中心自1998年1月至2008年1月共手术治疗96例脑瘫患者,其中47例患者行双侧L_3～S_1 SPR,49例患者行SPA.术后2周、1年测定患者下肢肌张力以及运动功能改善情况.结果术后2周行2种术式的患者肌张力、运动功能的改善差异均无统计学意义(P>0.05);术后1年行2种术式的患者肌张力的改善差异无统计学意义(P>0.05).但实施SPA患者运动功能改善优于SPR患者,差异有统计学意义(P<0.05).结论实施SPA患者运动功能的改善较好,短期内治疗效果不明显,而长期随访疗效显著.
목적 관찰병비교뇌탄환자실시선택성척신경후근절단술(SPR)화신경근부분절단병역행교차문합술(SPA)적료효.방법 광동성제이인민의원화해방군제88의원전군골과중심자1998년1월지2008년1월공수술치료96례뇌탄환자,기중47례환자행쌍측L_3～S_1 SPR,49례환자행SPA.술후2주、1년측정환자하지기장력이급운동공능개선정황.결과 술후2주행2충술식적환자기장력、운동공능적개선차이균무통계학의의(P>0.05);술후1년행2충술식적환자기장력적개선차이무통계학의의(P>0.05).단실시SPA환자운동공능개선우우SPR환자,차이유통계학의의(P<0.05).결론 실시SPA환자운동공능적개선교호,단기내치료효과불명현,이장기수방료효현저.
Objective To compared the therapeutic effect of selective posterior rhizotomy(SPR)and selective posterior anastomosis(SPA)on children with cerebral palsy.Methods The postoperative follow-up was carried out in 96 patients with cerebral palsy,including 47 children performed bilateral SPR from L_3 level to S_1 level and 49 children performed SPA from the distal ends of L_3 level to L_5 level and from L_4 level to S_1 level,respectively.The tension and myotatic reflex of the lower limbs were estimated 2 w and 1 y after operation.Results Follow-up was conducted for 12 to 18 months on these patients.No significant difference on tension and myotatic reflex was found between patients performed SPR and that performed SPA 2 w after the operation(P>0.05).No significant difference of muscular tension,but statistic difference of motor function in the patients performed SPA was showed as compared with that in the patients performed SPR 1 y after the operation(P>0.05).Conclusion Long-term follow-up shows great motor function improvement on patients performed SPA.