CAJ | 학술논문

目的：观察A型肉毒毒素(BTX-A)注射缓解脑瘫患儿髂腰肌痉挛的疗效。方法2006年7月~2012年10月，37例存在髂腰肌痉挛的脑瘫患儿，年龄3~15岁，分为对照组(n=20)和试验组(n=17)。对照组患儿采用常规的物理治疗(PT)康复训练，试验组患儿在常规康复训练的基础上增加BTX-A注射治疗。共治疗8周。根据患儿体重和改良Ashworth量表(MAS)评分来确定BTX-A剂量，每次用量为在15~45 IU之间，平均(31.2±13.9) IU。结果两组患儿的年龄、体重、治疗前的MAS评分、粗大运动功能测试(GMFM)评分、髋关节屈曲角度均无有显著性差异(P>0.05)。两组患儿治疗后的MAS评分、髋关节屈曲角度较治疗前有所降低， GMFM评分有所提高。对照组的GMFM评分较治疗前升高(P<0.05)，试验组的三项数据较治疗前均有显著性差异(P<0.05)。两组患儿治疗后三项数据均有显著性差异(P<0.05)。结论 BTX-A注射可以有效缓解脑瘫儿童髂腰肌痉挛。
목적：관찰A형육독독소(BTX-A)주사완해뇌탄환인가요기경련적료효。방법2006년7월~2012년10월，37례존재가요기경련적뇌탄환인，년령3~15세，분위대조조(n=20)화시험조(n=17)。대조조환인채용상규적물리치료(PT)강복훈련，시험조환인재상규강복훈련적기출상증가BTX-A주사치료。공치료8주。근거환인체중화개량Ashworth량표(MAS)평분래학정BTX-A제량，매차용량위재15~45 IU지간，평균(31.2±13.9) IU。결과량조환인적년령、체중、치료전적MAS평분、조대운동공능측시(GMFM)평분、관관절굴곡각도균무유현저성차이(P>0.05)。량조환인치료후적MAS평분、관관절굴곡각도교치료전유소강저， GMFM평분유소제고。대조조적GMFM평분교치료전승고(P<0.05)，시험조적삼항수거교치료전균유현저성차이(P<0.05)。량조환인치료후삼항수거균유현저성차이(P<0.05)。결론 BTX-A주사가이유효완해뇌탄인동가요기경련。
Objective To observe the effect of Botulinum toxin-A (BTX-A) injection on spastic iliopsoas in the children with cerebral palsy. Methods July 2006 to August 2012, 37 cerebral palsy children with spastic iliopsoas were treated. The age ranged from 3 to 15 years. The control group (n=20) was treated by physical therapy. The experimental group (n=17) accepted BTX-A injection in addition. The dose of BTX-A block was identified with the weight of the child and the modified Ashworth Scale (MAS). The dose of injection ranged from 15 IU to 45 IU, average (31.2±13.9) IU. Results There was no significant difference between 2 groups in age, weight, MAS score, Gross Motor Function Measure (GMFM) score and extension angle of hip joints before treatment (P>0.05). In both groups, the MAS score decreased, GMFM score and extension angle of hip joints increased after 8 weeks. In the control group, the GMFM score improved significantly (P<0.05). In the experimental group, MAS score, GMFM score and extension angle of hip joints changed significantly after treatment. There was significant difference between 2 groups in MAS score, GMFM score and extension angle of hip joints after treatment (P<0.05). Conclu-sion The BTX-A injection can relieve iliopsoas spasticity on the children with cerebral palsy efficiently.