A型肉毒毒素治疗脊髓损伤痉挛状态的临床研究  

A clinical study on Botulinum toxin A in treatment for spasticity in spinal cord injury

作　　者：敖丽娟[1] 钱菁华[1] 郑琳[1] 唐梅[1] 王文丽[1] 徐霁华[1] 

机构地区：[1]昆明医学院第二附属医院康复医学科,昆明麻园1号650101

出　　处：《中国康复医学杂志》2003年第2期94-96,共3页Chinese Journal of Rehabilitation Medicine

摘　　要：目的 :研究A型肉毒毒素对脊髓损伤痉挛状态的治疗作用。方法 :选择 9例脊髓损伤痉挛状态患者的 76块对功能影响较大且改良Ashworth分级≥Ⅱ级的痉挛肌进行A型肉毒毒素多点注射 ,记录治疗前及治疗后 3天、1周、1个月、2个月、3个月痉挛肌改良Ashworth分级、痉挛性疼痛评分 (VAS)、夜间抽搐的频率、内收肌角、直腿抬高角及FIM运动分的变化。结果 :注射后 3天即有 72 .3 %靶肌的改良Ashworth分级下降 (P <0 .0 1 ) ,1个月时所有靶肌 (1 0 0 % )的改良Ashworth分级显著下降 (P <0 .0 1 ) ,60 %的靶肌疗效持续时间≥ 3个月。注射后痉挛性疼痛(VAS)、夜间抽搐的频率、内收肌角、直腿抬高角显著改善 (P <0 .0 1 ) ,FIM运动分注射 1个月后持续改善 (P <0 .0 1 )。结论 :A型肉毒毒素对脊髓损伤痉挛性疼痛、抽搐及痉挛性关节活动度障碍有明显疗效 。Objective: To investigate the effects of botulinum toxin A(BTXA) for spasticity in spinal cord injury (SCI). Method: Nine SCI patients with spasticity were include in the study, 76 muscles with an Modified Ashworth scale ≥Ⅱwere injected with BTXA in different spots, and patients were observed. Modified Ashworth scale (MAS), Visual Analogous Scale (VAS), frequency of clonus in the night, adductor angle, length of hip flexor angle, Functional Independence Measure (FIM) were carried out from before treatment, and 3 days, 1week, 1 months, 2 months and 3months after the injection. Result: After 3 days, 72.3% muscles′ MAS were decreased significantly ( P <0.01) At 1 month , all muscles′ MAS were decreased significantly ( P <0.01). The effect of 60% of the muscles was ≥3 months. VAS, frequency of clonus in the night, adductor angle and length of hip flexor angle were significantly improved ( P <0.01), FIM was improved prominently after 1 month ( P <0.01). Conclusion: BTXA injection is an effective therapy for spasticity in SCI. The movement ability could be improved with rehabilitation training. Author′s address Dept. of Rehabilitation Medicine, The Second Affiliated Hospital, Kunming Medical College, 650101

关 键 词：A型肉毒毒素 脊髓损伤 痉挛状态 痉挛性疼痛 康复训练 

分 类 号：R651.2[医药卫生—外科学]