双侧痉挛型脑瘫患儿选择性脊神经后根切断术术前及术后步态特征  

Preoperative and postoperative gait characteristics analysis on bilateral spastic cerebral palsy children after selective posterior rhizotomy

作　　者：于江龙[1,2] 买尔阿芭[1] 木塔力甫·努热合买提[1] 艾克拜尔·哈力克[1] 刘亮[1] 栾新平[1] 

机构地区：[1]新疆医科大学第二附属医院神经外科,乌鲁木齐830063 [2]新疆巴州人民医院神经外科

出　　处：《中华实验外科杂志》2015年第5期1165-1167,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 评估脑瘫患儿选择性脊神经后根切断术（SPR）术观察其对步态各指标的影响.方法 收集脑瘫患儿12例（男6例,女6例）,平均年龄6.2岁,同期正常体检的年龄、性别匹配的12例（男6例,女6例）发育正常的儿童被纳入对照组,平均年龄为6.1岁.对脑瘫患儿行选择性脊神经后根切断术,记录脑瘫患儿术前、术后6个月及正常对照组的步频、起步期时间百分比、迈步期时间百分比、双下肢同时着地时间百分比、步长、步速等步态学指标.结果 与术前比较,大运动功能分级系统分级评分（GMFM）在术后6个月后显著增加,从（89.6±5.4）分上升至（94.3±4.3）分,两组比较差异有统计学意义（P＜0.05）,修正Ashworth量表痉挛状态评分（MAS）在术后6个月后显著降低,从（1.6±0.4）分降至（0.6±0.5）分,两组比较差异有统计学意义（P＜0.05）.术前、术后脑瘫患儿及正常对照儿童的步频差异有统计学意义（P＜0.01）.与正常儿童比较,术前脑瘫患儿的步频、起步期时间百分比、双下肢同时着地时间百分比较高;迈步期时间百分比、步长、步速较低（P＜0.05）.与术前比较,术后6个月后患儿步频、起步期时间百分比显著降低;步长、迈步期时间百分比显著增加（P＜0.05）,双下肢同时着地时间百分比、步速在两组间差异无统计学意义（P＞0.05）.结论 SPR术可以显著改善脑瘫患儿运动能力,步态学分析可以在SPR用于术后评估.Objective Cerebral palsy （CP） is a progressive brain dysfunction syndrome.The bilateral spasm is the most common clinical symptoms.The selective posterior rhizotomy （SPR） is one of the commonly used operation for reducing spasm in cerebral palsy.This study was aimed to assess preoperative and postoperative gait characteristics in bilateral spastic cerebral palsy children after SPR.Methods Study included 12 cases children with cerebral palsy （6 male and 6 female）,the average age was 6.2 years.During the same period,12 cases （6 male and 6 female） of age,sex,matched normal developed children were included in the control group,the average age was 6.1 years.Cadence,stance phase time percentage,swing phase time percentage,double limb support time percentage,stride length,velocity were documented in cerebral palsy children before SPR,6 months after SPR and control subjects.Results Compared with the preoperative group,GMFM score significantly increased after 6 months after surgery,it rose from （89.6 ± 5.4） to （94.3 ± 4.3）,the difference between the two groups have statistical significance （P 〈 0.05）,MAS score decreased significantly after 6 months after surgery,it drop from （1.6 ±0.4） to （0.6 ± 0.5）,the difference between the two groups was statistically significant （P 〈 0.05）.The stride length showed significant differences in preoperative and postoperative cerebral palsy patients and normal control children （P 〈 0.01）.Compared with normal control children,preoperative cadence,stride length,stance phase time percentage,double limb support time percentage were significantly higher,meanwhile,swing phase time percentage,stride length,velocity were significantly lower in preoperative children （P 〈 0.05）.Compared with preoperative children,6 months postoperative had decreased cadence,stance phase time percentage and increased stride length,swing phase time percentage （P 〈0.05）.Double limb support time percentage and velocity showed no significant difference pr

关 键 词：脑瘫 双侧痉挛型 选择性脊神经后根切断术 步态 

分 类 号：R726.5[医药卫生—儿科]