周围神经选择性切断治疗脑瘫性下肢痉挛  

Selective peripheral denervation for lower limbs spasm in patients with cerebral palsy

作　　者：张继武[1] 赵明[1] 梁树立[1] 查炜光[1] 邰军利[1] 

机构地区：[1]解放军总医院第一附属医院神经外科,北京100048

出　　处：《中国临床神经外科杂志》2010年第3期135-137,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨周围神经选择性切断治疗脑瘫性下肢痉挛的效果。方法对380例脑瘫性下肢痉挛患者,根据痉挛部位不同,选择相应周围神经(包括腰骶段脊神经后根、坐骨神经、闭孔神经和胫神经)部分切断。结果术后痉挛缓解率100%,其中82例患者肌力下降,142例患者出现肢体麻木、感觉减退,随访期间均见好转。术后随访6个月～3年,随访期间痉挛缓解率为95%。95%患者行走步态好转。结论周围神经选择性切断术对治疗脑瘫性下肢痉挛是安全、有效的。Objective To explore the therapeutic effect of selective peripheral denervation on lower limbs spasm in the patients with cerebral palsy. Methods The clinical data of 380 patients with low limbs spasm due to cerebral palsy, who underwent selective peripheral denervation from January, 2003 to March, 2008, were analyzed retrospectively. Based on the position of spasticity, corresponding selective peripheral neurotomy was performed. The nerves which were cut offincluded spinal dorsal root of lumbosacral region, sciatic nerve, obturator nerve, and tibial nerve. Results The relief rate of the lower limbs spasm was 100% after the neurotomy in 380 patients. The operative complications included decrease in the muscle strength the involved limbs in 82 cases and numbness or sensory disturbance of the involved limb in 142 cases. All the cases were followed up from 6 months to 3 years. The relief rate of the limbs spasm is 95% and 95% of the patients improved in walking manner during the following up. Conclusion The selective peripheral denervation is a safe and effective method to treat lower limbs spasm in the patients with cerebral palsy.

关 键 词：周围神经 去神经 脑瘫 下肢痉挛 

分 类 号：R651.3[医药卫生—外科学] R742.3[医药卫生—临床医学]