摘要
目的探讨超声引导下A型肉毒毒素（BTX—A）注射治疗脑性瘫痪儿童上肢肌肉痉挛的疗效。方法选择上肢肌肉痉挛的脑性瘫痪儿童20例，分为超声引导下BTX-A注射组（注射组）和单纯康复治疗组（对照组）各10例。其中注射组在彩色超声引导下，将BTX—A准确注射到患儿上肢痉挛肌群，注射后次日开始进行康复训练。所有病例在治疗前及治疗后第1周、2周、4周、8周、12周分别采用改良Ashworth量表和Fugl—Meyer评估量表进行相关评价。结果注射组在注射后第2，4，8，12周肌肉痉挛的改善以及上肢运动功能评分均优于注射前（P〈0．01），并且痉挛程度在注射后第2周改善最明显。注射组治疗效果明显优于对照组，2组间的差异具有统计学意义（P〈0．05）。结论采用在超声引导下BTX—A注射治疗脑性瘫痪儿童上肢肌肉痉挛，定位准确、安全，疗效优于单纯康复治疗。
Objective To evaluate the clinical effect of ultrasound-guided botulinum toxin A （BTX-A） injection for upper limb spasticity in children with cerebral palsy. Methods Twenty children with upper limb spasticity resulting from cerebral palsy were divided equally into a BTX-A injection group and a control group. Both groups received standard rehabilitation treatment. For the injection group, color ultrasonography was used to guide the accurate injection of BTX-A into the spastic muscles of the arm. They received rehabilitation training the day af- ter the injection. For all patients, muscle spasticity and upper limb movement and function were evaluated before treatment and 1, 2, 4, 8 and 12 weeks later using a modified Ashworth scale and the Fugl-Meyer assessment. Results After two weeks of treatment, muscle spasticity and upper limb movement and function in the injection group were significantly better than before the injection. The improvement in muscle spasticity was greatest two weeks after the injection. The average therapeutic effect in the injection group was significantly better than among the controls. Conclusion BTX-A injection under ultrasound guidance helps relieve upper limb spasticity in cerebral palsy. It has the advantages of accurate localization and safety and gives superior results compared to rehabilitation treatment alone.
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2011年第7期535-539,共5页
Chinese Journal of Physical Medicine and Rehabilitation
关键词
肉毒毒素
超声
脑性瘫痪
上肢痉挛
Botulinum toxin
Ultrasound
Cerebral palsy
Upper limb
Spasticity
