CAJ | 학술논문

目的：比较周围神经缩窄术与A型肉毒毒素注射治疗痉挛型脑瘫疗效及副作用,探讨痉挛性脑瘫的最适治疗方式及其效果。方法将118例患者随机分为A、B、C三组,3组患者均接受正规功能训练(每周5次,连续3个月以上), A组48例,给予周围神经缩窄术。B组28例,给予A型肉毒毒素注射治疗, C组42例,正规功能训练,(每周5次,连续3个月以上)；观察对比3组患者的临床疗效及副作用。结果 A、B两组患者经治疗后日常生活能力、神经功能缺损程度评分明显改善；A组总有效率为93.75%, B组总有效率为92.86%,均高于C组(59.52%),差异有统计学意义(P<0.05)；但A、B两组疗效差异无统计学意义(P>0.05)。另外, A组有9例患者手术后肌力不同程度下降,4例患者肌肉痉挛不同程度复发,B组均出现暂时性不同程度局部疼痛。结论周围神经缩窄术与A型肉毒毒素注射治疗效果均优于常规治疗,可更好地改善患者神经缺损程度,提高患者生活质量,但其也带来不同程度的副作用。因此,须严格掌握适应证并结合患者特点采取个体化治疗。
목적：비교주위신경축착술여A형육독독소주사치료경련형뇌탄료효급부작용,탐토경련성뇌탄적최괄치료방식급기효과。방법장118례환자수궤분위A、B、C삼조,3조환자균접수정규공능훈련(매주5차,련속3개월이상), A조48례,급여주위신경축착술。B조28례,급여A형육독독소주사치료, C조42례,정규공능훈련,(매주5차,련속3개월이상)；관찰대비3조환자적림상료효급부작용。결과 A、B량조환자경치료후일상생활능력、신경공능결손정도평분명현개선；A조총유효솔위93.75%, B조총유효솔위92.86%,균고우C조(59.52%),차이유통계학의의(P<0.05)；단A、B량조료효차이무통계학의의(P>0.05)。령외, A조유9례환자수술후기력불동정도하강,4례환자기육경련불동정도복발,B조균출현잠시성불동정도국부동통。결론주위신경축착술여A형육독독소주사치료효과균우우상규치료,가경호지개선환자신경결손정도,제고환자생활질량,단기야대래불동정도적부작용。인차,수엄격장악괄응증병결합환자특점채취개체화치료。
Objective To compare the effect and side-effect of peripheral neurotomy and botulinum toxin type A in the treatment of spastic cerebral palsy. Methods The 96 children with spastic cerebral palsy were randomly divided into three groups. They all received treatment of brain protein hydrolysate and normal function training. And the function training include 5 times every week for three months. On this condition, children of group A accepted peripheral neurotomy, and children of group B accepted botulinum toxin type A. Results After treatment, ADL and NIHSS of children in group A and B were improved than before. The effective rate of group A (93.75%) was obviously higher than group C(56.25%), and group B(90.63%) vice versa. The differences had statistics meaning(P<0.05). But the differences of group A and B were not significant(P>0.05). Conclusion Peripheral neurotomies and botulinum toxin type A in treatment of spastic cerebral palsy are superior than conventional treatment. The two treatmens can enhance activities of daily living and improve levels of neurologic impairment.