CAJ | 학술논문

目的：探讨A型肉毒毒素（BTX-A）配合康复训练治疗儿童脑外伤后肢体痉挛性运动障碍的疗效。方法采用前瞻性随机对照研究，选取脑外伤后肢体痉挛性运动障碍的患儿44例。随机分为两组。治疗组：注射A型肉毒毒素+康复训练组22例（其中上肢痉挛12例、下肢痉挛10例）。对照组：单纯康复训练组22例（其中上肢痉挛10例、下肢痉挛组12例）。分别观察治疗前、治疗后4周、8周、12周时用改良Ashworth量表、粗大运动功能评估量表（GMFM）进行评估。结果治疗组与对照组之间同期比较，其改良Ashworth量表、粗大运动功能评估量表评估均优于对照组，差异有统计学意义（P<0.05）。治疗组中上肢痉挛患儿改良Ashworth评估及粗大运动功能评估量表评估优于下肢痉挛患儿，差异有统计学意义（P<0.05）。结论 A型肉毒毒素注射治疗联合康复训练对儿童脑外伤后痉挛性运动障碍的改善有较好作用，且上肢痉挛者获益可能优于下肢痉挛者。
목적：탐토A형육독독소（BTX-A）배합강복훈련치료인동뇌외상후지체경련성운동장애적료효。방법채용전첨성수궤대조연구，선취뇌외상후지체경련성운동장애적환인44례。수궤분위량조。치료조：주사A형육독독소+강복훈련조22례（기중상지경련12례、하지경련10례）。대조조：단순강복훈련조22례（기중상지경련10례、하지경련조12례）。분별관찰치료전、치료후4주、8주、12주시용개량Ashworth량표、조대운동공능평고량표（GMFM）진행평고。결과치료조여대조조지간동기비교，기개량Ashworth량표、조대운동공능평고량표평고균우우대조조，차이유통계학의의（P<0.05）。치료조중상지경련환인개량Ashworth평고급조대운동공능평고량표평고우우하지경련환인，차이유통계학의의（P<0.05）。결론 A형육독독소주사치료연합강복훈련대인동뇌외상후경련성운동장애적개선유교호작용，차상지경련자획익가능우우하지경련자。
ObjectiveTo investigate the effect of botulinum toxin A(BTX-A)injection on spasticity in children with acquired brain injury(ABI).MethodsThis is a prospective randomized controlled study. 44 children with limbs spasticity after brain injury were divided into two groups randomly. Treatment group(n=22):botulinum toxin A treatment and routine rehabilitation training (12chileren with up limbs spasticity and 10children with lower limbs spasticity). Control group(n=22):routine rehabilitation training only(10 children with up limbs spasticity and 12children with lower limbs spasticity). We used Modifi ed Ashworth Scale and Gross Motor Function Measure to assess the children before and 4weeks,8 weeks,12 weeks after treatment.ResultsClinical results showed that the Modifi ed Ashworth Scale and Gross Motor Function Measure of treatment group were superior to control group (P<0.05). In treatment group,the Modifi ed Ashworth Scale and Gross Motor Function Measure of up limbs spasticity children were superior to lower limbs spasticity children(P<0.05).ResultsA combination of BTX-A injection with rehabilitation is an interesting optionfor treatment of spasticity children after brain injury. The effects in up limbs spasticity children were superior to lower limbs spasticity children.