脑瘫尖足内翻畸形的功能重建及A型肉毒毒素配合治疗的临床分析
뇌탄첨족내번기형적공능중건급A형육독독소배합치료적림상분석
Clinical research of functional reconstruction with BTA for treatment on equinovarus foot of spasitic cerebral palsy
  • 万方数据
    中华显微外科杂志 중화현미외과잡지
    Chinese Journal of Microsurgery
    2011年 2期 122-124 ,共3页

    李智勇%易建华%黎建文%顾立强%刘小林%劳镇国%朱庆棠%向剑平%戚剑%王洪刚%王东%秦本刚

    리지용%역건화%려건문%고립강%류소림%로진국%주경당%향검평%척검%왕홍강%왕동%진본강

    脑瘫%足内翻畸形%功能重建%A型肉毒毒素 腦癱%足內翻畸形%功能重建%A型肉毒毒素
    뇌탄%족내번기형%공능중건%A형육독독소
    Cerebral palsy%Eguinovarus foot%Functional reconstruction%Botulinum toxin A (BTA)
    目的 探讨脑瘫尖足内翻畸形的功能重建及A型肉毒毒素配合治疗的临床疗效.方法 收集2000年1月至2009年1月在我科住院行尖足内翻畸形矫正的痉挛性脑瘫,术后小腿三头肌的肌张力Ⅱ级以上者共32例,给予A型肉毒毒素局部注射治疗,观察手术和药物注射前后的功能改善情况并进行比较.结果 检杳治疗前踝背伸肌力在0～2级,随访时踝背伸的肌力为4～5级,采用配对t检验,术前后比较差异有统计学意义(P＜0.05).治疗前足内翻在30°～75°之间,随访时足内翻在0°～25°,采用配对t检验,治疗前后数据的差异有统计学意义(P＜0.05).小腿三头肌2个月复查时,肌张力在Ⅱ～Ⅳ级,随访时肌张力在Ⅰ～Ⅱ级.采用配对t检验,术前后比较差异有统计学意义(P＜0.05).结论 胫后肌前移配合A型肉毒毒素可同时减轻肌张力和改善踝背伸肌力,提高脑瘫的足部畸形的临床疗效.
    목적 탐토뇌탄첨족내번기형적공능중건급A형육독독소배합치료적림상료효.방법 수집2000년1월지2009년1월재아과주원행첨족내번기형교정적경련성뇌탄,술후소퇴삼두기적기장력Ⅱ급이상자공32례,급여A형육독독소국부주사치료,관찰수술화약물주사전후적공능개선정황병진행비교.결과 검묘치료전과배신기력재0～2급,수방시과배신적기력위4～5급,채용배대t검험,술전후비교차이유통계학의의(P＜0.05).치료전족내번재30°～75°지간,수방시족내번재0°～25°,채용배대t검험,치료전후수거적차이유통계학의의(P＜0.05).소퇴삼두기2개월복사시,기장력재Ⅱ～Ⅳ급,수방시기장력재Ⅰ～Ⅱ급.채용배대t검험,술전후비교차이유통계학의의(P＜0.05).결론 경후기전이배합A형육독독소가동시감경기장력화개선과배신기력,제고뇌탄적족부기형적림상료효.
    Objective To observe the clinical therapial value of functional reconstruction with Botulinum Toxin A (BTA) on spasitic cerebral palsy. Methods Thirty-two patients were treated by Achilles tendon lengthening and anterior transfer of posterior tibial tendon.According to the spasticity of triceps surae muscle,all cases were arranged by BTA injection 2 months later after operation.Results From Jan.2000 to Jan.2009,thirty-two cases with equinovarus foot of spasticitical cerebral palsy were collected,the muscle strength of ankle dorsal extensor increased from 0-2 grades to 4-5 grades,there was significant difference between preoperational muscle strength and postoperational one.There was also significant improvement to adjust yarus degrees of ankle joint.the musclar tension of triceps muscle of calf decreased from Ⅱ-Ⅳ grades to Ⅰ-Ⅱ grades. Conclusion Anterior transfer of posterior tibial tendon corresponding with Botulinum Toxin A injection not only release muscle spasticity but also improve dorsal extending strength of ankle joint.The clinical effect of these methods was reliable on cerebral palsy.
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