基于循证医学的脑性瘫痪康复治疗新进展  

Evidence-based new progress in interventions of cerebral palsy

作　　者：李晓捷[1,2] 梁玉琼 Li Xiaojie;Liang Yuqiong(Department of Cerebral Palsy Rehabilitation,the Third Affiliated Hospital of Jiamusi University,Jiamusi 154002,Heilongjiang Province,China;Institute of Pediatric Neurological Disorders,Jiamusi University,Jiamusi 154002,Heilongjiang Province,China;The Third Department of Rehabilitation,Xi′an Traditional Chinese Medicine Brain Disease Hospital Affiliated to Shaanxi University of Traditional Chinese Medicine,Xi′an 710000,China)

机构地区：[1]佳木斯大学附属第三医院脑瘫康复科,黑龙江佳木斯154002 [2]佳木斯大学小儿神经疾病研究所,黑龙江佳木斯154002 [3]陕西中医药大学附属西安中医脑病医院康复治疗三科,西安710000

出　　处：《中华实用儿科临床杂志》2020年第12期885-889,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家卫生计生委卫生行业科研专项(201002006)。

摘　　要：脑性瘫痪(简称脑瘫)是引起儿童肢体功能障碍的常见疾病,其康复干预措施众多,给临床方案选择带来了巨大挑战。根据循证医学研究,有效的脑瘫预防措施包括产前使用糖皮质激素、硫酸镁和新生儿治疗性低温。有效的健康干预措施包括限制性诱导运动疗法、目标导向性活动运动集成法、注射肉毒毒素后的作业治疗、移动性训练、跑步机训练、运动观察疗法、目标导向性训练、双侧训练、口腔感觉运动、口腔感觉运动加电刺激、垫脚石3P计划、接受与承诺疗法等。有效的药理学、外科干预措施包括鞘内注射巴氯芬、肉毒毒素、肉毒毒素结合系列石膏固定、地西泮、选择性脊神经根切断术、髋关节监测等。Cerebral palsy(CP)is a common disease that causes physical disability in children.There are many rehabilitation interventions,which bring great challenges to the choice of clinical programs.Evidence-based me-dicine suggests that antenatal corticosteroids,magnesium sulfate,and neonatal hypothermia are effective prevention stra-tegies for CP.Efficient allied health interventions include constraint-induced movement therapy,goals-activity-motor enrichment,botulinum toxin plus occupational therapy,mobility training,treadmill training,action observation therapy,goal-directed training,bimanual training,oral sensorimotor,oral sensorimotor plus electrical stimulation,stepping stones triple P,acceptance and commitment therapy,and so on.Useful medical and surgical interventions are intrathecal Baclofen therapy,botulinum toxin,botulinum toxin plus casting,Diazepam,selective dorsal rhizotomy,hip surveillance,and so on.

关 键 词：脑性瘫痪 早期预防 早期干预 运动干预 肌张力管理 

分 类 号：R742.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学] R-03