脑外伤后上肢痉挛患者注射A型肉毒毒素治疗的临床探索  

Clinical Exploration of Botulinum Toxin A Injection in Patients with Upper Limb Spasm after Brain Trauma

作　　者：滕以亮 李娜[1] 马国欣[1] 李燕燕 陈晓琳[1] 李铁山[2] TENG Yiliang;LI Na;MA Guoxin;LI Yanyan;CHEN Xiaolin;LI Tieshan(People’s Hospital of Shinan District in Qingdao,Qingdao 266002,China;不详)

机构地区：[1]青岛市市南区人民医院,山东青岛266002 [2]青岛大学附属医院

出　　处：《中外医学研究》2021年第3期126-128,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:研究脑外伤后上肢肌痉挛注射A型肉毒毒素(BTXA)治疗的临床研究。方法:选择43例2018年9月-2019年12月于青岛市市南区人民医院康复科及青岛大学附属医院康复科就诊的脑外伤后上肢肌痉挛患者,患者发病3~6个月入A组,9~12个月入B组。两组患者均进行常规治疗及患侧肢体康复训练。不同时间注射肉毒毒素治疗上肢肌痉挛。比较注射前和注射后2、4、8周的改良Ashworth肌痉挛量表(MAS)、Fugl-Meyer运动功能评测(FMA)的评定情况。结果:治疗后2、4、8周A组MAS评定等级明显优于治疗前及B组,差异有统计学意义(P<0.05);治疗后2、4、8周A组FMA评分明显优于治疗前及B组,差异有统计学意义(P<0.05)。结论:脑外伤后上肢肌痉挛的患者,发病3~6个月上肢局部注射A型肉毒毒素后,肢体功能改善明显优于发病9~12个月后的患者。Objective:To study the clinical effect of Botulinum Toxin A (BTXA) injection on upper limb muscle spasm after traumatic brain injury.Method:From September 2018 to December 2019,43 patients with upper limb muscle spasm after traumatic brain injury were selected from the Rehabilitation Department of People’ Hospital of Shinan District in Qingdao and the Rehabilitation Department of Qingdao University Affiliated Hospital.The patients were admitted to group A within 3-6 months and group B within 9-12 months.Patients in both groups were given routine treatment and rehabilitation training of affected limbs,and was injected with Botulinum Toxin to treat upper limb muscle spasm at different time.The evaluation of modified Ashworth muscle spasm scale (MAS) and Fugl-Meyer assessment of motor function (FMA) before injection and 2,4 and 8 weeks after injection were compared.Result:After 2,4 and 8 weeks of treatment,the evaluation grade of MAS in group A was obviously better than that before treatment and in group B,and the difference was statistically significant (P<0.05).The FMA scores of the group A were significantly better than those before treatment and the group B at 2,4 and 8 weeks after treatment,and the difference was statistically significant (P<0.05).Conclusion:The limb function of patients with upper limb muscle spasm after traumatic brain injury after local injection of Botulinum Toxin A in upper limbs for 3-6 months is obviously better than that of patients after 9-12 months.

关 键 词：A型肉毒毒素 脑外伤 肌痉挛 

分 类 号：R657.15[医药卫生—外科学]