混合性脑瘫的外科治疗  

Surgical treatment of mixed type cerebral palsy

作　　者：张晓华[1] 李勇杰[1] 胡永生[1] 张宇清[1] 马凯[1] 

机构地区：[1]首都医科大学宣武医院功能神经外科北京功能神经外科研究所,北京100053

出　　处：《中国微侵袭神经外科杂志》2006年第12期532-534,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：首都医学发展基金项目(2002-3023)

摘　　要：目的探讨立体定向核团毁损加选择性脊神经后根切断术治疗混合性脑瘫的手术疗效。方法对6例混合性脑瘫病人行立体定向苍白球腹后内侧部(Gpi,3例)或丘脑底核(STN,3例)毁损,加选择性脊神经后根切断术(L2～S1 5例,C5～C8 1例),手术同期进行2例,间隔约2周后分期进行4例。随访24个月,观察手术肢体痉挛、肌张力障碍及运动功能改善情况。结果6例病人Ashworth痉挛评分及Fahn肌张力障碍评分降低,运动功能明显改善。结论应用立体定向核团毁损加选择性脊神经后根切断术治疗混合性脑瘫疗效可靠。Objective To study the efficacy of stereotactic nucleus lesioning with selective posterior rhizotomy （SPR） in treatment of mixed type cerebral palsy. Methods All 6 patients in our study received stereotactic nucleus lesioning （globus pallidus intemus and subthalamic nucleus, each 3 cases） and SPR （L2-S1 for 5 cases, C5-C8 for l case）. The nucleus lesioning and SPR were carried out simultaneously in 2 patients and at a 2-week interval in 4. Limb spasticity, dystonia and motor function were observed for 24 months by following-up. Results Ashworth spasticity scale and Fahn rating scale scores were reduced in all the 6 patients, and significant improvement was achieved in motor ability. Conclusion Combination of stereotactic nucleus lesioning with SPR provides a significant improvement of motor function in treatment of mixed type cerebral palsy.

关 键 词：脑性瘫痪 放射外科手术 选择性脊神经后根切断术 

分 类 号：R651.1[医药卫生—外科学]