遗传性痉挛性截瘫的神经外科治疗  

Neurosurgical management of hereditary spastic paraplegia

作　　者：苗素华[1] 王世杰[1] 陈业涛[1] 王东[1] 王云朋[1] 王凯[1] 左焕琮[1] 

机构地区：[1]清华大学玉泉医院神经神经外科,北京100049

出　　处：《立体定向和功能性神经外科杂志》2011年第3期138-140,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的 ;探讨遗传性痉挛性截瘫的神经外科治疗方法及其疗效。方法对17例遗传性痉挛性截瘫患者施行周围神经缩窄术,其中单纯周围神经缩窄术12例,周围神经缩窄＋矫形术5例。采用改良Asworth分级评定患者的痉挛程度,采用简化Fugl-Meyer量表评估患者下肢运动功能的改善。结果随访8~15个月,平均12个月。术后近期痉挛缓解率为98.5%,随访期间为92.7%。术后近期下肢运动改善率为86.5%,随访期间为90.8%。2例（11.8%）患者下肢出现短暂的感觉障碍,随访期间均消失。1例（5.9%）严重痉挛患者术后伴有肌力减低。2例（11.8%）患者随访期间痉挛复发。结论遗传性痉挛性截瘫患者适时适当的进行外科手术治疗能够较好地缓解痉挛,改善下肢运动功能,延缓病程进展。Objective To explore the methods and effectiveness of neurosurgical management of hereditary spastic paraplegia.Methods Selective peripheral neurotomy（SPN） was carried out in 17 patients,including 12 SPN and 15 SPN＋orthomorphia.Modified Asworth scale was employed to estimated the patients＇ muscle tone.And the Fugl-Meyer scores was applied to assessed the motor function of lower limbs.Results All patients were followed up from 8 to 15 months（means 12 months）.The postoperative spasticity relief rate is 98.5% and the follow-up is 92.7%.The improvement of patients＇ motor function in lower limbs is 80.5% after the operation and 90.8% by follow-up.Temporary sensory disturbance in lower limbs occurred in 2 cases postoperatively and disappeared by follow-up.Muscle weakness with severe spasm occurred in one case.The spasm recured in 2 cases by follow up.Conclusion With strictly control indications,the neurosurgery can effectively relief spasm,improve motor function and delay the development in lower limbs of hereditary spastic paraplegia patients.

关 键 词：遗传性痉挛性截瘫 神经外科手术 周围神经缩窄 

分 类 号：R596[医药卫生—内科学]