中华物理医学与康复杂志
中華物理醫學與康複雜誌
중화물리의학여강복잡지
CHINESE JOURNAL OF PHYSICAL MEDICINE AND REHABILITATION
2011年
7期
535-539
,共5页
肉毒毒素%超声%脑性瘫痪%上肢痉挛
肉毒毒素%超聲%腦性癱瘓%上肢痙攣
육독독소%초성%뇌성탄탄%상지경련
Botulinum toxin%Ultrasound%Cerebral palsy%Upper limb%Spasticity
目的 探讨超声引导下A型肉毒毒素( BTX-A)注射治疗脑性瘫痪儿童上肢肌肉痉挛的疗效。方法 选择上肢肌肉痉挛的脑性瘫痪儿童20例，分为超声引导下BTX-A注射组（注射组）和单纯康复治疗组（对照组）各10例。其中注射组在彩色超声引导下，将BTX-A准确注射到患儿上肢痉挛肌群，注射后次日开始进行康复训练。所有病例在治疗前及治疗后第1周、2周、4周、8周、12周分别采用改良Ashworth量表和Fugl-Meyer评估量表进行相关评价。结果 注射组在注射后第2，4，8，12周肌肉痉挛的改善以及上肢运动功能评分均优于注射前(P＜0.01)，并且痉挛程度在注射后第2周改善最明显。注射组治疗效果明显优于对照组,2组间的差异具有统计学意义(P＜0.05)。结论采用在超声引导下BTX-A注射治疗脑性瘫痪儿童上肢肌肉痉挛，定位准确、安全，疗效优于单纯康复治疗。
目的 探討超聲引導下A型肉毒毒素( BTX-A)註射治療腦性癱瘓兒童上肢肌肉痙攣的療效。方法 選擇上肢肌肉痙攣的腦性癱瘓兒童20例，分為超聲引導下BTX-A註射組（註射組）和單純康複治療組（對照組）各10例。其中註射組在綵色超聲引導下，將BTX-A準確註射到患兒上肢痙攣肌群，註射後次日開始進行康複訓練。所有病例在治療前及治療後第1週、2週、4週、8週、12週分彆採用改良Ashworth量錶和Fugl-Meyer評估量錶進行相關評價。結果 註射組在註射後第2，4，8，12週肌肉痙攣的改善以及上肢運動功能評分均優于註射前(P＜0.01)，併且痙攣程度在註射後第2週改善最明顯。註射組治療效果明顯優于對照組,2組間的差異具有統計學意義(P＜0.05)。結論採用在超聲引導下BTX-A註射治療腦性癱瘓兒童上肢肌肉痙攣，定位準確、安全，療效優于單純康複治療。
목적 탐토초성인도하A형육독독소( BTX-A)주사치료뇌성탄탄인동상지기육경련적료효。방법 선택상지기육경련적뇌성탄탄인동20례，분위초성인도하BTX-A주사조（주사조）화단순강복치료조（대조조）각10례。기중주사조재채색초성인도하，장BTX-A준학주사도환인상지경련기군，주사후차일개시진행강복훈련。소유병례재치료전급치료후제1주、2주、4주、8주、12주분별채용개량Ashworth량표화Fugl-Meyer평고량표진행상관평개。결과 주사조재주사후제2，4，8，12주기육경련적개선이급상지운동공능평분균우우주사전(P＜0.01)，병차경련정도재주사후제2주개선최명현。주사조치료효과명현우우대조조,2조간적차이구유통계학의의(P＜0.05)。결론채용재초성인도하BTX-A주사치료뇌성탄탄인동상지기육경련，정위준학、안전，료효우우단순강복치료。
Objective To evaluate the clinical effect of ultrasound-guided botulinum toxin A (BTX-A)injection for upper limb spasticity in children with cerebral palsy.Methods Twenty children with upper limb spasticity resulting from cerebral palsy were divided equally into a BTX-A injection group and a control group. Both groups received standard rehabilitation treatment. For the injection group, color ultrasonography was used to guide the accurate injection of BTX-A into the spastic muscles of the arm. They received rehabilitation training the day after the injection. For all patients, muscle spasticity and upper limb movement and function were evaluated before treatment and 1, 2, 4, 8 and 12 weeks later using a modified Ashworth scale and the Fugl-Meyer assessment.Results After two weeks of treatment, muscle spasticity and upper limb movement and function in the injection group were significantly better than before the injection.The improvement in muscle spasticity was greatest two weeks after the injection. The average therapeutic effect in the injection group was significantly better than among the controls.Conclusion BTX-A injection under ultrasound guidance helps relieve upper limb spasticity in cerebral palsy. It has the advantages of accurate localization and safety and gives superior results compared to rehabilitation treatment alone.
