CAJ | 학술논문

目的观察和比较系列石膏联合肉毒毒素和单独使用肉毒毒素注射治疗脑瘫患儿马蹄足畸形的疗效.方法将入选的腩瘫患儿60例按患儿接受治疗的先后顺序编号,采用半随机对照的方法将编号为单数的患儿纳入实验组,编号为偶数的患儿纳入对照组,每组30例,2组患儿均接受肉毒毒素注射治疗,实验组则增加系列石膏治疗.于治疗前、治疗后1个月、治疗后3个月和治疗后6个月观察其踝关节在伸膝和屈膝时的背屈度,并行观察性步态分析.结果治疗前,2组患者间的伸膝时踝关节背屈度、屈膝时踝关节背屈度和观察性步态量表评分差异无统计学意义(P＞0.05),治疗后1、3和6个月,2组患者在伸膝时踝关节背屈度、屈膝时踝关节背屈度和观察性步态量表评分分别与组内治疗前比较,差异均有统计学意义(P＜0.05),实验组在治疗后1、3和6个月的伸膝时踝关节背屈度、屈膝时踝关节背屈度和观察性步态量表评分分别与对照组同时间点比较,差异均有统计学意义(P＜0.05).结论系列石膏联合肉毒毒素注射疗法比单独使用肉毒毒素治疗痉挛型脑瘫患儿马蹄足畸形的疗效更好,可更好地降低患儿肌肉痉挛的程度,改善关节活动度和步态,疗效持续时间更长.
목적 관찰화비교계렬석고연합육독독소화단독사용육독독소주사치료뇌탄환인마제족기형적료효.방법 장입선적남탄환인60례안환인접수치료적선후순서편호,채용반수궤대조적방법장편호위단수적환인납입실험조,편호위우수적환인납입대조조,매조30례,2조환인균접수육독독소주사치료,실험조칙증가계렬석고치료.우치료전、치료후1개월、치료후3개월화치료후6개월관찰기과관절재신슬화굴슬시적배굴도,병행관찰성보태분석.결과 치료전,2조환자간적신슬시과관절배굴도、굴슬시과관절배굴도화관찰성보태량표평분차이무통계학의의(P＞0.05),치료후1、3화6개월,2조환자재신슬시과관절배굴도、굴슬시과관절배굴도화관찰성보태량표평분분별여조내치료전비교,차이균유통계학의의(P＜0.05),실험조재치료후1、3화6개월적신슬시과관절배굴도、굴슬시과관절배굴도화관찰성보태량표평분분별여대조조동시간점비교,차이균유통계학의의(P＜0.05).결론 계렬석고연합육독독소주사요법비단독사용육독독소치료경련형뇌탄환인마제족기형적료효경호,가경호지강저환인기육경련적정도,개선관절활동도화보태,료효지속시간경장.
Objective To compare the effect of injection with botulinum toxin type A (BTX-A) before serial casting with BTX-A injection alone for the treatment of spastic equinus in children with cerebral palsy (CP).Methods Sixty patients were divided into an experimental group and a control group with 30 patients in each.Those io the experimental group received a BTX-A injection followed by serial casting,while the controls received BTX-A only.Before treatment and 1 month,3 months and 6 months after treatment,the dorsiflexion range of motion (ROM)of the ankle recorded while the knee in flexion and extension were measured,and gait was evaluated with an observational gait scale.Results Before treatment there was no significant inter-group difference in any of the 3 outcome measures.At 1 montb,3 months and 6 months after treatment,there were significant inter-group differences in all 3 measures,and also significant differences compared with before treatment in both groups.Conclusion Lower muscle tone,greater ankle mobility and better gait patterns can be promoted in CP children with spastic equinus using serial casting combined with BTX-A injection.The improvements may last longer than those after BTX-A injection alone.