A型肉毒毒素联合康复训练治疗肌张力障碍型脑瘫的疗效观察  

Therapeutic effect of botulinum toxin type A combined with rehabilitation training on dystonic cerebral palsy

作　　者：刘建军[1] 齐婧[1] 张雁[1] 曾凡勇[1] 李南玲[1] 刘亚楠[1] LIU Jianjun;QI Jing;ZHANG Yan;ZENG Fanyong;LI Nanling;LIU Ya’nan(Capital Medical University School of Rehabilitation Medicine, China Rehabilitation Research Center,Beijing 100068,China)

机构地区：[1]首都医科大学康复医学院中国康复研究中心

出　　处：《中国现代医生》2019年第18期20-23,27,共5页China Modern Doctor

摘　　要：目的观察A型肉毒毒素(BTX-A)注射联合康复训练治疗肌张力障碍型脑瘫的疗效,探讨其对脑瘫儿童的运动功能和生活自理能力的提高作用。方法选择2014年6月~2018年12月接受康复治疗的肌张力障碍型的脑瘫患儿46例。将46例脑瘫患儿随机分为对照组和实验组。对照组开展常规康复训练,实验组在康复训练的基础上,增加肉毒毒素注射。在康复治疗前、康复治疗后2个月,分别对两组患儿采用GMFM、BBS、ADL评定量表进行评价。结果两组患儿治疗前的GMFM、BBS、ADL比较均无显著性差异(P>0.05)。两组患儿康复治疗2个月后的GMFM、BBS、ADL较术前有显著提高,相较于对照组,实验组患儿的GMFM、BBS、ADL分数提高得更显著(P<0.05)。有1例患儿出现轻微副作用。结论 BTX-A阻滞术可有效缓解肌张力障碍型脑瘫儿童的肌肉过度收缩,此疗法联合康复训练,可以提高疗效,提高生活自理能力。Objective To observe the efficacy of botulinum toxin type A(BTX-A) injection combined with rehabilitation training on the treatment of dystonic cerebral palsy, and to explore the effect of this treatment on the motor function and self-care ability of children with cerebral palsy. Methods From June 2014 to December 2018, 46 children with dystonic cerebral palsy were treated with rehabilitation treatment. 46 children with cerebral palsy were randomly divided into two groups. The control group was given routine rehabilitation training, and the experimental group was treated with the injection of botulinum toxin on the basis of rehabilitation training. Before the rehabilitation treatment and at two months after the rehabilitation treatment, the two groups of children were evaluated by GMFM, BBS and ADL rating scales.Results There were no significant differences in GMFM, BBS, and ADL between the two groups before treatment(P>0.05).The GMFM, BBS and ADL of the two groups were significantly improved after two months of rehabilitation. Compared with those of the control group, the GMFM, BBS and ADL scores of the experimental group were significantly higher(P<0.05). One child had mild side effects. Conclusion BTX-A block can effectively relieve the muscle excessive contraction in children with dystonic cerebral palsy. This therapy combined with rehabilitation training can improve the curative effect and improve the self-care ability of life.

关 键 词：脑性瘫痪 肌张力障碍 A型肉毒毒素 康复 

分 类 号：R742[医药卫生—神经病学与精神病学] R725[医药卫生—临床医学]