《中国康复理论与实践》

《中国康复理论与实践》 ›› 2012, Vol. 18 ›› Issue (10): 901-904.

• 论文 •    下一篇

A型肉毒毒素治疗脑性瘫痪患儿上肢痉挛的疗效分析

刘建军，吴卫红，张雁，曾凡勇，李南玲   

  1. 1.首都医科大学康复医学院，北京市100068；2.中国康复研究中心北京博爱医院儿童康复科，北京市100068。
  • 收稿日期:2012-04-12 修回日期:2012-05-10 出版日期:2012-10-25 发布日期:2012-10-25

Effect of Botulinum Toxin Type A Treatment on Upper Extremity Spasticity in Children with Cerebral Palsy

LIU Jian-jun, WUWei-hong, ZHANG Yan, et al   

  1. Capital Medical University School of Rehabilitation Medicine, China Rehabilitation Research Centre, Beijing 100068, China
  • Received:2012-04-12 Revised:2012-05-10 Published:2012-10-25 Online:2012-10-25

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摘要： 目的分析A型肉毒毒素(BTX-A)阻滞术缓解脑瘫患儿上肢痉挛的疗效。方法将2004 年1 月~2011 年12 月本院收治47 例痉挛型偏瘫的脑瘫患儿分为对照组(n=25)和试验组(n=22)。对照组接受常规作业康复训练，试验组在此基础上接受上肢BTX-A 阻滞术治疗。根据试验组患儿体重和改良Ashworth 评分(MAS)来确定BTX-A 剂量，每次用量在30~110 IU 之间，平均(50.7±12.7) IU。结果治疗前，两组患儿MAS、简易上肢功能检查法评分均无显著性差异(P>0.05)。试验组治疗后MAS评分明显低于治疗前(P<0.01)，且低于对照组(P<0.05)。两组患儿的上肢功能评分均有提高(P<0.05)，试验组提高值明显高于对照组(P<0.01)。结论BTX-A可有效降低脑瘫儿童的上肢肌张力，有助于上肢运动功能的提高。

关键词: 脑性瘫痪, 痉挛, 偏瘫, A型肉毒毒素, 上肢, 运动功能, 神经阻滞

Abstract:

Objective To analyze the effect of Botulinum toxin-A (BTX-A) block on the upper extremity spasticity in children with cerebral palsy. Methods From January 2004~December 2011, 47 children with spastic hemiplegic cerebral palsy were divided into control group (n=25) and experimental group (n=22). The control group was administered by occupational therapy. The experimental group was treated by BTX-A block in addition. The dose of BTX-A block was identified with the body weight of the child and the Modified Ashworth Scale (MAS). The dose of injection ranged from 30 IU to 110 IU, average (50.7±12.7) IU. Results There was no significant difference between 2 groups in scores of MAS and Simple Test for Evaluating Hand Function (STEF) before treatment (P>0.05). The MAS score reduced in the experimental group 1 month after treatment (P<0.01), and was lower in the experimental group than in the control group (P<0.05). The score of STEF increased in both groups (P<0.05), and it was higher in the experimental group than in the control group (P<0.01). Conclusion The BTX-A block can decline the upper extremity muscle tone in children with cerebral palsy efficiently, and help to improve the upper extremity function.

Key words: cerebral palsy, spasm, hemiplegia, Botulinum toxin type A, upper extremity, motor function, nerve block