CAJ | 학술논문

目的：探讨A型肉毒毒素（B T X‐A ）对痉挛型脑瘫患儿足底压力改变的影响。方法：213例痉挛型脑瘫患儿随机分为B T X‐A组108例（B T X‐A注射结合物理治疗）和对照组105例（单纯物理治疗）。2组患儿在医院接受2周康复治疗，之后在家接受10周家庭康复治疗。在治疗前、治疗后2周和12周，对2组患儿进行以下评定：足底压力测试仪测试足底各区压力占全足的百分比，粗大运动功能测试量表中的站立与步行功能项评定粗大运动功能，改良Ashworth量表评定痉挛程度，医师等级评价量表评定步态。结果：BTX‐A组的足底各区压力分布、站立和步行功能、痉挛程度和步态，在治疗后2周、12周与治疗前比较，均有明显改善（ P＜0．05）；对照组各项评分在治疗12周后才有明显改善（ P＜0．05）；治疗后12周，2组间的足底各区压力分布、站立和步行功能、痉挛程度和步态进行比较，BTX‐A组均明显优于对照组（P＜0．05）。结论：BTX‐A注射结合物理治疗更利于改善痉挛型脑瘫患儿的足底压力分布、缓解其肌肉痉挛、提高其步行能力、改善其步态。
목적：탐토A형육독독소（B T X‐A ）대경련형뇌탄환인족저압력개변적영향。방법：213례경련형뇌탄환인수궤분위B T X‐A조108례（B T X‐A주사결합물리치료）화대조조105례（단순물리치료）。2조환인재의원접수2주강복치료，지후재가접수10주가정강복치료。재치료전、치료후2주화12주，대2조환인진행이하평정：족저압력측시의측시족저각구압력점전족적백분비，조대운동공능측시량표중적참립여보행공능항평정조대운동공능，개량Ashworth량표평정경련정도，의사등급평개량표평정보태。결과：BTX‐A조적족저각구압력분포、참립화보행공능、경련정도화보태，재치료후2주、12주여치료전비교，균유명현개선（ P＜0．05）；대조조각항평분재치료12주후재유명현개선（ P＜0．05）；치료후12주，2조간적족저각구압력분포、참립화보행공능、경련정도화보태진행비교，BTX‐A조균명현우우대조조（P＜0．05）。결론：BTX‐A주사결합물리치료경리우개선경련형뇌탄환인적족저압력분포、완해기기육경련、제고기보행능력、개선기보태。
Objective:To compare the effects of botulinum toxin A (BTX‐A ) injection plus physiotherapy ,or physiotherapy alone on the food pressure in children with spastic cerebral palsy (SCP) .Methods:213 children with SCP were randomly divided into two groups :BTX‐A group (BTX‐A injections combined with physical therapy ,108 cases) and control group (physical therapy ,105 cases) .Two groups received 2 weeks of hospital‐based physiothera‐py ,and 10 weeks of home‐based physiotherapy .Outcome assessments included foot pressure measured by GHW type plantar pressure tester ,modified Ashworth scale (MAS) ,D and E dimensions of the Gross Motor Function Measure (GMFM ) ,and physician rating scale was determined before and 2 ,12 weeks after treatment .Results:Children in BTX‐A group showed an improvement of foot pressure ,spasticity ,standing and walking ,gait 2 and 12 weeks after treatment as compared with those before treatment (P<0 .05) .These scores in control group were im‐proved at 12th week only .Furthermore ,there was significant difference in foot pressure ,spasticity ,standing and walking ,gait between two groups at 12th week (P<0 .05) .Conclusion:BTX‐A injection combined with physical therapy was advantageous in improving foot pressure ,spasticity ,walking ,and gait in children with SCP .