A型肉毒毒素在治疗儿童脑外伤后肢体痉挛中的应用  

作　　者：曾晓艳[1] 董燕[1] 吴涛[2] 陈波[1] 

机构地区：[1]武警浙江总队杭州医院康复医学科,310051 [2]浙江大学医学院附属邵逸夫医院康复医学科,310020

出　　处：《浙江临床医学》2014年第12期1900-1901,1904,共3页Zhejiang Clinical Medical Journal

摘　　要：目的：探讨A型肉毒毒素（BTX-A）配合康复训练治疗儿童脑外伤后肢体痉挛性运动障碍的疗效。方法采用前瞻性随机对照研究，选取脑外伤后肢体痉挛性运动障碍的患儿44例。随机分为两组。治疗组：注射A型肉毒毒素＋康复训练组22例（其中上肢痉挛12例、下肢痉挛10例）。对照组：单纯康复训练组22例（其中上肢痉挛10例、下肢痉挛组12例）。分别观察治疗前、治疗后4周、8周、12周时用改良Ashworth量表、粗大运动功能评估量表（GMFM）进行评估。结果治疗组与对照组之间同期比较，其改良Ashworth量表、粗大运动功能评估量表评估均优于对照组，差异有统计学意义（P＜0.05）。治疗组中上肢痉挛患儿改良Ashworth评估及粗大运动功能评估量表评估优于下肢痉挛患儿，差异有统计学意义（P＜0.05）。结论 A型肉毒毒素注射治疗联合康复训练对儿童脑外伤后痉挛性运动障碍的改善有较好作用，且上肢痉挛者获益可能优于下肢痉挛者。ObjectiveTo investigate the effect of botulinum toxin A（BTX-A）injection on spasticity in children with acquired brain injury（ABI）.MethodsThis is a prospective randomized controlled study. 44 children with limbs spasticity after brain injury were divided into two groups randomly. Treatment group（n=22）：botulinum toxin A treatment and routine rehabilitation training （12chileren with up limbs spasticity and 10children with lower limbs spasticity）. Control group（n=22）：routine rehabilitation training only（10 children with up limbs spasticity and 12children with lower limbs spasticity）. We used Modifi ed Ashworth Scale and Gross Motor Function Measure to assess the children before and 4weeks,8 weeks,12 weeks after treatment.ResultsClinical results showed that the Modifi ed Ashworth Scale and Gross Motor Function Measure of treatment group were superior to control group （P〈0.05）. In treatment group,the Modifi ed Ashworth Scale and Gross Motor Function Measure of up limbs spasticity children were superior to lower limbs spasticity children（P〈0.05）.ResultsA combination of BTX-A injection with rehabilitation is an interesting optionfor treatment of spasticity children after brain injury. The effects in up limbs spasticity children were superior to lower limbs spasticity children.

关 键 词：A型肉毒毒素 儿童 脑外伤 痉挛 

分 类 号：R745.12[医药卫生—神经病学与精神病学]