跟腱延长术治疗痉挛型脑性瘫痪患儿马蹄足的效果  

Effects of Achilles Tendon Lengthening on Talipes Equinus in Children with Spastic Cerebral Palsy

作　　者：方科[1] 李范玲[1] 肖晟[1] 李欣[1] 刘宏[1] 

机构地区：[1]湖南省人民医院小儿骨科,湖南长沙市410005

出　　处：《中国康复理论与实践》2017年第6期734-736,共3页Chinese Journal of Rehabilitation Theory and Practice

基　　金：湖南省教育厅课题(No.17C0971)

摘　　要：目的评估跟腱延长术治疗痉挛型脑瘫马蹄足的效果。方法 2013年12月至2014年6月接受跟腱延长术治疗的痉挛型脑瘫马蹄足患儿17例(34足),于术前、术后8~12个月分别进行踝关节背屈关节活动度(ROM)、小腿胫前后肌群表面肌电测试,记录踝关节被动背屈、主动背屈ROM,站立位胫前肌、腓肠肌肌电均方根值(RMS)和拮抗肌协同收缩率(CR)。结果术后踝关节主动、被动背屈ROM显著增加(Z>4.867,P<0.001);被动背屈时腓肠肌RMS减少(t=4.31,P<0.001),站立时胫前肌、腓肠肌RMS无显著性差异(Z<1.291,P>0.05),CR降低(t=2.38,P<0.05)。结论跟腱延长术可以改善痉挛型脑瘫马蹄足患儿小腿胫前后肌群协调收缩,增加踝ROM。Objective To evaluate the effects of Achilles tendon lengthening on talipes equinus in children with spastic cerebral palsy. Methods From December, 2013 to June, 2014, seventeen spastic cerebral palsy children with talipes equinus （34 feet） received Achilles ten- don lengthening. Ankle dorsiflexion range of motion （ROM） and surface eleetromyography from tibialis anterior and medial head of gastroc- nemius were measured before and 8 to 12 months after operation, respectively. ROM of passive and active dorsiflexion, root mean square （RMS） of tibia muscle group and cocontraction ratio （CR） when standing were compared. Results The ROM of ankle passive and active dorsiflexion increased （Z〉4.867, P〈0.001）, while the RMS of gastrocnemius muscle decreased when ankle passively dorsiflex （t=4.31, P〈 0.001）. RMS of tibialis anterior and gastroenemius muscle changed little when standing （Z〈1.291, P〉0.05）, while CR reduced （t=2.38, P〈 0.05）. Conclusion Achilles tendon lengthening can improve the coordination of tibia muscle group to increase the ROM of ankle for children with talipes equinus after spastic cerebral palsy.

关 键 词：脑性瘫痪 痉挛 马蹄足 跟腱延长术 表面肌电图 踝 

分 类 号：R742.3[医药卫生—神经病学与精神病学]