摘要
目的:探讨A型肉毒杆菌毒素(BTX-A)肩后伸肌群注射配合目标性训练对脑卒中患者后上肢功能的影响。方法:选取2014年9月至2016年9月皖北煤电集团总医院收治的脑卒中后上肢功能障碍患者100例,按照随机数字表法分为对照组和观察组,每组50例。对照组患者进行常规康复训练,观察组在常规康复训练的基础上予BTX-A肩后伸肌群注射。观察两组治疗前、后改良Ashworth量表(MAS)、Fugl-Meyer运动功能量表(FMA)和改良Barthel指数(MBI)评分以及清洁患侧手掌、给患手剪指甲、将患手放进袖子执行功能性活动评分情况。结果:治疗后5个月,两组患者的MAS、FMA和MBI评分均得到显著改善(均P<0.05),且观察组3项评分显著优于对照组(P<0.05)。治疗前,两组患者清洁患侧手掌、给患手剪指甲、将患手放进袖子执行功能性活动评分无明显差异(P>0.05),治疗后两组患者3项执行功能性活动评分均有所改善(均P<0.05),且观察组显著优于对照组(P<0.05)。结论:BTX-A肩后伸肌群注射配合目标性训练可有效改善脑卒中后上肢功能,提高患者执行功能性活动的能力。
Objective：To investigate the effect of type A botulinum toxin（BTX-A）injection combined with targeted training on upper limb function after stroke. Methods： A total of 100 patients with upper limb dysfunction after stroke in our hospital from September 2014 to September 2016 were enrolled,and were randomly divided into a control group and an observation group,with 50 cases in each group. The patients in the control group received routine rehabilitation training,and those in the observation group received rehabilitation training combined with BTX-A injection on the shoulder extensor. The scores of modified Ashworth scale（MAS）,FuglMeyer assessment（FMA）and modified Barthel index（MBI）before and after treatment was observed. Results： After 5 months of treatment,the MAS,FMA and MBI scores were significantly improved in both groups（P〈0. 05）. The improvement of MAS,FMA and MBI scores in the observation group were better than that in the control group（P〈0. 05）. Before treatment,there were no significant differences in the scores of cleaning the affected side of the palm,cutting the nails of affected side hand and putting the sick hand into the sleeves between the two groups（P〉0. 05）. The three functional activities scores were markedly improved after treatment（P〈0. 05）,and the improvement of functional activities in the observation group was significantly better than that in the control group（P〈0. 05）. Conclusion： BTX-A injection on the shoulder extensor combined with targeted training could effectively improve the post-stroke upper limb function and functional activities of patients.
出处
《广西医科大学学报》
CAS
2017年第12期1772-1775,共4页
Journal of Guangxi Medical University
关键词
A型肉毒杆菌毒素
脑卒中
上肢功能
botulinum toxin A
cerebral stroke
upper limb function
