CAJ | 학술논문

目的：观察体外冲击波对脑瘫患儿小腿三头肌痉挛的疗效和安全性。方法：脑瘫肌痉挛患儿50例分为观察组24例和对照组26例，2组均给予常规康复治疗，观察组加用冲击波治疗，治疗前后对2组患儿的被动关节活动度（PROM）、改良的Asworth分级（MAS）、粗大运动功能评分（GMFM）、足底支持面积和足底压力进行评定。结果：观察组治疗1周及4周后，小腿三头肌 MAS评分较治疗前明显下降（P＜0．05），且呈逐渐下降趋势（P＜0．05），且各时间段各项评分均更低于对照组（P＜0．05）；对照组治疗1周后，小腿三头肌 MAS评分及踝关节PROM与治疗前比较差异无统计学意义，治疗4周后，小腿三头肌 M AS评分较治疗前及治疗1周时明显下降（P＜0．05）。观察组治疗1周及4周后，踝关节 PROM、GMFM 评分、足底面积及足底压力均较治疗前明显增加（P＜0．05），且呈逐渐上升趋势（P＜0．05），且各时间段各项评分均更高于对照组（P＜0．05）；对照组治疗1周后，踝关节PROM、GM FM评分、足底面积及足底压力与治疗前比较差异无统计学意义，治疗4周后，踝关节PROM、GMFM评分、足底面积及足底压力均较治疗前及治疗1周时明显增加（P＜0．05）。结论：体外冲击波治疗可以降低脑瘫患儿小腿三头肌张力，缓解肌肉痉挛，改善其粗大运动功能。
목적：관찰체외충격파대뇌탄환인소퇴삼두기경련적료효화안전성。방법：뇌탄기경련환인50례분위관찰조24례화대조조26례，2조균급여상규강복치료，관찰조가용충격파치료，치료전후대2조환인적피동관절활동도（PROM）、개량적Asworth분급（MAS）、조대운동공능평분（GMFM）、족저지지면적화족저압력진행평정。결과：관찰조치료1주급4주후，소퇴삼두기 MAS평분교치료전명현하강（P＜0．05），차정축점하강추세（P＜0．05），차각시간단각항평분균경저우대조조（P＜0．05）；대조조치료1주후，소퇴삼두기 MAS평분급과관절PROM여치료전비교차이무통계학의의，치료4주후，소퇴삼두기 M AS평분교치료전급치료1주시명현하강（P＜0．05）。관찰조치료1주급4주후，과관절 PROM、GMFM 평분、족저면적급족저압력균교치료전명현증가（P＜0．05），차정축점상승추세（P＜0．05），차각시간단각항평분균경고우대조조（P＜0．05）；대조조치료1주후，과관절PROM、GM FM평분、족저면적급족저압력여치료전비교차이무통계학의의，치료4주후，과관절PROM、GMFM평분、족저면적급족저압력균교치료전급치료1주시명현증가（P＜0．05）。결론：체외충격파치료가이강저뇌탄환인소퇴삼두기장력，완해기육경련，개선기조대운동공능。
Objective:To investigate the curative effects and security of extracorporeal shock wave treatment for muscle spasticity in children with cerebral palsy .Methods:Fifty children with cerebral palsy of muscle spasticity were divided into the observation group (n=24) and control group (n=26) .Two groups received routine rehabilita‐tion .The observation group was given extracorporeal shock wave treatment additionally .Before and after treat‐ment ,muscle spasticity was evaluated by passive range of motion (PROM ) ,modified Ashworth scale (MAS) , Gross Motor Function Measure (GMFM) ,and foot contact area .Results:One week and 4 weeks after treatment , the MAS scores of triceps surae muscle were decreased in the observation group as compared with those before treat‐ment (P<0 .05) ,showing a gradually descent trend (P<0 .05) ,and the score of every item at any time point was significantly different as compared with that in the control group (P<0 .05) .One week after treatment ,the MAS scores of triceps surae muscle in the control group showed no statistically significant difference from those before treatment .Four weeks after treatment ,the scores of MAS in control group were decreased as compared with those pretreatment and one week after treatment (P<0 .05) .One week and 4 weeks after treatment ,the scores of ankle PROM ,Gross Motor Function Measure ,foot contact area ,and foot pressure were increased in the observation group as compared with those before treatment (P< 0 .05) ,showing a gradually descent trend (P< 0 .05) .The score of every item in the observation group was increased as compared with the control group at any time point (P<0 .05) .One week after treatment ,the scores of ankle PROM ,Gross Motor Function Measure ,foot contact ar‐ea ,and foot pressure showed no statistically significant difference in the control group as compared with those before treatment .Four weeks after treatment ,the scores of ankle PROM ,Gross Motor Function Measure ,foot contact ar‐ea ,and foot pressure were increased in the control group as compared with those before treatment and one week af‐ter treatment (P<0 .05) .Conclusion:Extracorporeal shock wave treatment can decrease triceps surae muscle ten‐sion ,release muscle spasm ,and improve gross motor function .