电刺激定位下注射A型肉毒毒素联合物理治疗脑性瘫痪患儿踝蹠屈肌群痉挛的临床价值分析  

Clinical Value of Injection of Botulinum Toxin A under the Guidance of Localization of Electrical Stimulation Combined with Physical Therapy in the Treatment of Spasm of Ankle Plantar Flexor in Children with Cerebral Palsy

作　　者：郑志宏 邓小蕾 黄亿彩 ZHENG Zhi-hong;DENG Xiao-lei;HUANG Yi-cai(Department of Pediatrics,the 909th Hospital of PLA Joint Logistics Support Forces,Zhangzhou,Fujian 363000,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇九医院儿科,福建漳州363000

出　　处：《解放军医药杂志》2020年第6期46-50,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：福建省教育厅科技资助项目(JT180214)。

摘　　要：目的分析电刺激定位下注射A型肉毒毒素(BTX-A)联合物理治疗脑性瘫痪患儿踝蹠屈肌群痉挛的临床价值。方法回顾性分析2016年6月—2019年6月收治的53例脑性瘫痪患儿的临床资料,根据治疗方法的不同分为研究组27例和对照组26例。对照组予以单纯物理治疗,研究组予以电刺激定位下注射BTX-A联合物理治疗。对比2组治疗前后的改良Ashworth量表(MAS)、综合痉挛量表(CSS)评分、步行速度及关节活动度的情况。结果治疗后2周、1和3个月,2组MAS评分、CSS评分、足背屈角活动度以及小腿三头肌、股内收肌、腘绳肌的MAS评分均较治疗前明显下降,且研究组明显低于对照组(P<0.05)。治疗后2周、1和3个月,2组内收肌角活动度、腘窝角活动度较治疗前均明显增加,且研究组明显大于对照组(P<0.05)。研究组治疗后2周、1和3个月的步行速度较治疗前明显上升,且治疗后1个月的步行速度高于对照组(P<0.05)。结论电刺激定位下注射BTX-A联合物理治疗脑性瘫痪患儿踝蹠屈肌群痉挛的临床效果佳,且安全可靠。Objective To analyze the clinical value of injection of Botulinum toxin A(BTX-A)under the guidance of localization of electrical stimulation combined with physical therapy in the treatment of spasm of ankle plantar flexor in children with cerebral palsy(CP).Methods The clinical data of 53 children with CP admitted from June 2016 to June 2019 were retrospectively analyzed.According to different treatment methods,they were divided into the research group(n=27)and the control group(n=26).The control group received physical therapy alone,and the research group received BTX-A under the guidance of localization of electrical stimulation combined with physical therapy.The modified Ashworth scale(MAS),comprehensive spasticity scale(CSS)scores,walking speed and joint mobility before and after treatment were compared between the two groups.Results At 2 weeks,1 and 3 months after treatment,the MAS score,CSS score,dorsiflexion angle activity,and the MAS scores of the triceps,adductor muscle,and hamstring muscles of the two groups were significantly lower than those before treatment,and the indicators in the research group were significantly lower than those in the control group(P<0.05).At 2 weeks,1 and 3 months after treatment,the adductor angle activity and popliteal angle activity in both groups were significantly increased compared with those before treatment,which were significantly larger in the research group than those in the control group(P<0.05).The walking speed of the study group at 2 weeks,1 and 3 months after treatment was significantly higher than that before treatment,and the walking speed at 1 month after treatment was higher than that of the control group(P<0.05).Conclusion In the treatment of CP children with spasm of ankle plantar flexor muscle,the injection of BTX-A under the guidance of localization of electrical stimulation combined with physical therapy has a good clinical effect as a safe and reliable approach.

关 键 词：脑性瘫痪 痉挛 肌 骨骼 电刺激 A型肉毒毒素 物理治疗 

分 类 号：R742.3[医药卫生—神经病学与精神病学]