高选择性脊神经后根切断术治疗痉挛性脑瘫  

Superselective posterior rhizotomy for treatment of spastic cerebral palsy

作　　者：赵东升[1] 姬西团[1] 费舟[1] 贺晓生[1] 刘卫平[1] 黄钢[1] 王正君[1] 梁景文[1] 李娜[1] 

机构地区：[1]第四军医大学西京医院神经外科,陕西西安710032

出　　处：《中华神经外科疾病研究杂志》2014年第2期153-155,共3页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的 探讨应用高选择性脊神经后根切断术（SPR）治疗痉挛性脑瘫的疗效.方法 对58例接受SPR治疗的痉挛性脑瘫患者,进行术后8～40个月的随访,并对其术后痉挛情况、交叉腿、尖足情况、肌力、感觉等情况进行评估.结果 14例肌张力Ⅳ级的患者术后平均肌张力降为1.71级,32例肌张力Ⅲ级的患者术后平均肌张力降为1.56级,12例肌张力Ⅱ级的患者术后平均肌张力降为1.16级.30例剪刀步态完全消失（51.72％）,19例明显改善（32.76％）,仍有9例改善不明显（15.51％）.合并尖足者共31例,术后足跟着地者27例.术后随访能独立行走者29例（50％）,需搀扶者18例（31.03％）,不能行走者11例（18.97％）.结论 SPR对解除痉挛、降低肌张力等方面是安全可靠、作用持久的,配合必要的康复训练,可明显改善肢体活动功能,提高生活质量.Objective The efficacy of superselective posterior rhizotomy （SPR） for treatment of spastic cerebral palsy is investigated.Methods A total of 58 patients with spastic cerebral palsy receiving SPR treatment were followed up for 8 to 40 months to evaluate the postoperative condition of spasm,cross legs,plantar flexion malformation,muscle strength and feeling,etc.Results The Ⅳ muscle tension of 14 patients descended to 1.71 level after operation,Ⅲ muscle tension of 32 patients descended to 1.56 level,and Ⅱ muscle tension of 12 patients descended to 1.16 level after operation.Scissors gait completely disappeared in 30 cases （51.72%）,significant improvement in 19 cases （32.76%）,and no obvious improvement （15.51%） in 9 cases after operation.Twenty seven of 31 cases with plantar flexion malformation were improved after operation.During the long-term follow-up after operation,29 cases （50%） could walk alone,18 cases （31.03%） needed to arm,and 11 cases （18.97%） were still unable to walk.Conclusion SPR is a safe and reliable method to relief cramnps and decrease muscle tension,therefore it can improve the quality of life and the physical activity with the necessary rehabilitation training.

关 键 词：高选择性脊神经后根切断术 痉挛性脑瘫 康复训练 

分 类 号：R651.1[医药卫生—外科学]