超声定位A型肉毒毒素治疗脑性瘫痪患儿下肢肌肉痉挛的疗效  

Curative effect of ultrasonic location botulinum toxin A injection for lower limbs spasticity in children with cerebral palsy

作　　者：李红[1] 童光磊[1] 易昕[1] 蔡云飞[1] 温祖芳[1] 肖昕[2] 

机构地区：[1]安徽省立儿童医院神经康复科,合肥230051 [2]安徽省立儿童医院B超室,合肥230051

出　　处：《中华实用儿科临床杂志》2013年第13期1014-1016,共3页Chinese Journal of Applied Clinical Pediatrics

基　　金：安徽省卫生厅课题（20088074）;安徽省卫生厅中医药管理局课题（2012zy63）

摘　　要：目的 观察超声定位A型肉毒毒素（BTX-A）注射治疗脑性瘫痪患儿下肢肌肉痉挛的疗效。方法 选择下肢肌肉痉挛的脑性瘫痪患儿75例，分为超声定位BTX-A注射治疗组37例（注射组）和单纯康复治疗组38例（对照组）。其中注射组在超声定位后予BTX-A 注射患儿下肢痉挛肌群，注射后次日开始进行康复训练。所有患儿在治疗前及治疗2周、1个月、3个月、6个月分别采用改良Ashworth量表（MAS）和粗大运动功能量表（GMFM）行相关评价。结果 注射组在注射2周、1个月、3个月、6个月肌肉痉挛的改善及GMFM 评分均优于注射前（P均〈0.01），且痉挛程度在注射2周、1个月改善最明显。注射组治疗效果明显优于对照组（P 〈0.05）。注射组3个月和6个月 MAS评分差异无统计学意义，BTX-A 注射有时效性，6个月后可重复注射。结论 采用超声定位BTX-A注射治疗脑性瘫痪患儿下肢肌肉痉挛，定位准确、安全，患儿依从性好，疗效优于单纯康复治疗。Objective To evaluate the clinical effect of ultrasonic location botulinum toxin A （BTX-A） injec-tion for lower limbs spasticity in children with cerebral palsy. Methods Seventy-five children with lower limbs spasti-city resulting from cerebral palsy were divided into injection group（ n = 37） and control group （n = 38 ）. Uhrasonography was used to located the injection of BTX-A into the spastic muscles of the legs in injection group. Then rehabilitation training was received the day after the injection. For all patients, muscle spastieity and gross motor function measure were evaluated before treatment and in the second week, the first, third and sixth month treatment using the Modified Ashworth Scale（MAS） and the Gross Motor Function Measure（GMFM） assessment. Results In the second week,the first, third and the sixth month of treatment, the improvement of muscle spasticity and GMFM in the injection group were significantly better than before（ all P 〈 0.01 ）. And the improvement of muscle spasticity were the greatest in the second week and the first month of the injection. The average therapeutic effect in the injection group was significantly better than that in the control group（P 〈 0.05）. There was no statistical difference between the evaluation score of the third month and that of the sixth month for injection group. The BTX-A injection had time limit and could be reinject after 6 months. Conclusions The ultrasound located BTX-A injection to treat lower limbs spasticity in cerebral palsy has the advantages of accurate localization, safety, good child patient compliance and more effective than only rehabilitation treatment.

关 键 词：肉毒毒素 超声定位 脑性瘫痪 下肢痉挛 

分 类 号：R742.3[医药卫生—神经病学与精神病学]