《中国康复理论与实践》

《中国康复理论与实践》 ›› 2014, Vol. 20 ›› Issue (7): 641-644.

• 论文 • 上一篇    下一篇

抗痉挛治疗前后脑卒中患者超声肌肉结构参数的比较

杨远滨，张京，冷振鹏，张倩，陈昕，肖娟   

  1. 1.首都医科大学宣武医院，北京市100053；2.首都医科大学附属北京世纪坛医院，北京市100038；3.深圳大学医学院，广东深圳市518060。
  • 收稿日期:2014-04-14 修回日期:2014-06-04 出版日期:2014-07-25 发布日期:2014-07-25

Comparison of Muscle Architecture Parameters Measured by Ultrasound in Stroke before and after Antispastic Treatment

YANG Yuan- bin, ZHANG Jing, LENG Zhen- peng, et al.   

  1. Department of Rehabilitation, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
  • Received:2014-04-14 Revised:2014-06-04 Published:2014-07-25 Online:2014-07-25

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被引次数

11

摘要： 目的利用超声肌肉检查技术观察抗痉挛治疗前后脑卒中患者的肌肉结构参数(MAP)变化规律，并分析其在痉挛评价中的作用和价值。方法选取脑卒中后接受口服抗痉挛药物、抗痉挛体位摆放、痉挛肌牵伸训练和拮抗肌主动收缩训练等抗痉挛治疗的6 例患者作为研究对象。选取腓肠肌外侧头肌肉纤维作为研究靶肌肉，分别对健、患侧肢体进行评定和超声MAP测量。测量内容包括：改良Ashworth 量表(MAS)分级评定；MAP中的肌肉羽状角度(PA)、肌纤维长度(FL)和肌纤维厚度(MT)。分析抗痉挛治疗前、治疗后2 周及治疗后4 周MAS和MAP的变化趋势和规律。结果脑卒中患者随着抗痉挛治疗时间的增加，MAS评分、PA和MT出现下降趋势，FL出现上升趋势。其中MAS评分治疗前与治疗后2 周、4 周相比有显著性差异(P<0.05)，而治疗后2 周与治疗后4 周相比无显著性差异(P>0.05)；MAP参数中：FL不仅治疗前与治疗后4 周相比有显著性差异(P<0.05)，而且治疗后2 周与治疗后4 周相比较也有显著性差异(P<0.05)；PA治疗前与治疗后4 周比较有显著性差异(P<0.05)；而MT治疗前及治疗后2 周、4 周间比较均无显著性差异(P>0.05)。结论评定肌纤维肌张力的显著性变化时，MAS与MAP均具有良好的敏感性，结合应用MAS和MAP可以更加准确客观地评定肌张力的细微变化，从而更好地评定临床抗痉挛治疗效果，指导治疗。

关键词: 超声, 肌肉结构参数, 脑卒中, 痉挛, 评价

Abstract: Objective To observe the changes of muscle architecture parameters (MAP) in stroke by ultrasound before and after antispasmodic treatment. Methods 6 spastic hemplegic stroke patients were enrolled. All patients accepted anti- spastic rehabilitation training and took oral antispastic medicine. The muscle tone was assessed with modified Ashworth Scale (MAS), and MAP was measured by ultrasound before, 2 weeks and 4 weeks after treatment. MAP included pennation angle (PA), fascicle length (FL) and muscular thickness (MT). All data were analyzed. Results There were significant difference in MAS between baseline level and 2 weeks, and 4 weeks after treatment (P<0.05). There were significant difference in FL and PA between baseline level and 4 weeks after treatment (P<0.05). There were statistical significance in FL between 2 weeks and 4 weeks after treatment as well (P<0.05). With the treatment, the difference in MAS, FL, PA and MT decreased between both side legs. Conclusion MAP and MAS are sensitive in evaluating the significant change of muscle tone. MAP combined with MAS may be optimal choice for evaluating antispasticity effects in poststroke.

Key words: ultrasound, muscle architecture parameters, stroke, spasticity, evaluation