体外冲击波治疗脑瘫病儿小腿三头肌痉挛的临床效果  

CLINICAL EFFECT OF EXTRACORPOREAL SHOCKWAVE THERAPY IN TREATMENT OF SPASTICITY OF TRICEPS SURAE MUSCLE IN CHILDREN WITH CEREBRAL PALSY

作　　者：武玉霞 郭飞[3] 姚秋英 于建波[2] 沈顺姬[4] 李铁山[1] WU Yuxia;GUO Fei;YAO Qiuying;YU Jianbo;SHEN Shunji;LI Tieshan(Department of Rehabilitation Medicine,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院康复医学科,山东青岛266003 [2]威海市立医院康复治疗科 [3]威海市立医院超声科 [4]威海市立医院康复医学科

出　　处：《青岛大学学报（医学版）》2021年第4期559-562,共4页Journal of Qingdao University(Medical Sciences)

基　　金：山东省自然科学基金资助项目(ZR2018MH031)。

摘　　要：目的探讨体外冲击波疗法对脑瘫病儿小腿三头肌痉挛的治疗效果及其作用机制。方法将19例脑瘫伴小腿三头肌痉挛的病儿随机分为体外冲击波治疗组(ESWT组,10例)和对照组(9例)。两组病儿除进行常规康复训练外,ESWT组给予体外冲击波治疗,对照组给予体外冲击波假性治疗,均每周治疗1次,共治疗2个月。分别于治疗前后评估两组病儿的足背屈角、改良Ashworth分级(MAS)、改良Tardieu量表(MTS)评分、腓肠肌内侧头(GM)厚度、Heckmatt量表评分、粗大运动功能评定量表(GMFM)评分,并进行比较。结果与治疗前比较,对照组和ESWT组病儿治疗后足背屈角、MAS评分、MTS评分均降低,GM厚度、GMFM评分均升高,差异有显著性(t=-13.127~13.682,P<0.05);Heckmatt评分差异无显著性(P>0.05)。两组病儿治疗前各指标比较,差异均无显著性(P>0.05)。两组足背屈角、MAS评分、MTS评分、GM厚度及GMFM评分治疗前后差值比较,差异均有显著性(t=-6.341~4.782,P<0.05);Heckmatt评分治疗前后差值比较差异无显著性(P>0.05)。结论体外冲击波疗法可有效改善脑瘫病儿小腿三头肌的痉挛状态。Objective To investigate the clinical effect and mechanism of action of extracorporeal shockwave therapy(ESWT)in the treatment of spasticity of triceps surae muscle in children with cerebral palsy.Methods A total of 19 children with cerebral palsy and spasticity of triceps surae muscle were randomly divided into ESWT group with 10 children and control group with 9 children.In addition to routine rehabilitation training,the children in the ESWT group received ESWT,and those in the control group received sham ESWT,once a week for 2 months.The two groups were compared in terms of foot dorsiflexion angle,Modified Ashworth Scale(MAS)score,Modified Tardieu Scale(MTS)score,thickness of medial head of gastrocnemius muscle,Heckmatt Scale score,and Gross Motor Function Measure(GMFM)score.Results After treatment,both groups had significant reductions in foot dorsiflexion angle,MAS score,and MTS score and significant increases in thickness of medial head of gastrocnemius muscle and GMFM score(t=-13.127 to 13.682,P<0.05),while there was no significant change in Heckmatt score(P>0.05).There were no significant differences in the above indices between the two groups before and after treatment(P>0.05).There were significant differences between the two groups in the changes in foot dorsiflexion angle,MAS score,MTS score,thickness of medial head of gastrocnemius muscle,and GMFM score after treatment(t=-6.341 to 4.782,P<0.05),while there was no significant difference in the change in Heckmatt score after treatment(P>0.05).Conclusion ESWT can effectively improve spasticity of triceps surae muscle in children with cerebral palsy.

关 键 词：体外冲击波疗法 脑性瘫痪 肌痉挛状态 治疗结果 

分 类 号：R493[医药卫生—康复医学] R682.22[医药卫生—临床医学]