肉毒毒素注射结合功能训练对痉挛型脑性瘫痪患儿粗大运动功能的影响  

Effects of botulinum toxin injection in conjunction with functional training on gross motor function in children with spastic cerebral palsy

作　　者：蒋虹 徐开寿[2] 李金玲[2] 何璐[2] 麦坚凝[2] 

机构地区：[1]桂林市人民医院儿科,广西桂林541002 [2]广州市儿童医院神经康复科,广东广州510120

出　　处：《中国儿童保健杂志》2008年第5期535-536,共2页Chinese Journal of Child Health Care

摘　　要：【目的】探讨A型肉毒毒素（BTX-A）注射结合功能训练对痉挛型脑瘫患儿粗大运动功能的影响。【方法】将42例痉挛型脑瘫患儿随机分为治疗组（采用BTX-A注射结合功能训练）和对照组（仅应用功能训练）,两组治疗前及治疗后2周、1月、3月、6月采用综合痉挛评分量表和粗大运动功能量表进行疗效评估。【结果】治疗组自2周后、对照组自1月后下肢痉挛度下降（P〈0.05）;下肢痉挛度组间比较2周-3月,治疗组明显下降（P〈0.001）。治疗组1月起、对照组6月后站立（D区）和走跑跳（E区）评分比治疗前提高（P〈0.05）;3、6月组间比较,D、E区评分差异有显著性（P〈0.05）。【结论】BTX-A注射与功能训练结合能快速有效的提高痉挛型脑瘫患儿的粗大运动功能,缓解肢体痉挛。【Objective】 To study the effects of botulinum toxin A（BTX-A）injection in conjunction with functional training in children with spastic cerebral palsy（SCP）. 【Methods】 Fourty-two children with SCP were randomly divided into a treatment group（groupⅠ）and a control group（groupⅡ）.The twenty-two children in groupⅠ were treated with BTX-A and functional training,while those in groupⅡ were treated with functional training alone.Composite Spasticity Scale（CSS） and Gross Motor Function Measure（GMFM） were performed before treatment and at 2 weeks,and 1,3 and 6 months after treatment. 【Results】 The spasticity was reduced in group Ⅰ after 2 weeks of treatment and in group Ⅱ after 1 month of treatment.They were maintained at 6 months after treatment.When comparing with the results before treatment,the improvement of standing and walking（GMFM） was statistically significant after 1 month of treatment,and maintained at 6 months of treatment.Furthermore,the differences of CSS and GMFM between 2 groups at 3 months examination were also statistically significant. 【Conclusion】 BTX-A injection in conjunction with functional training is more effective on reducing spasticity and improving gross motor function in children with SCP.

关 键 词：A型肉毒毒素 粗大运动 脑瘫 痉挛 

分 类 号：R722.1[医药卫生—儿科]