肉毒毒素注射联合Vojta训练对痉挛型脑性瘫痪患儿下肢关节活动度及精细运动功能的影响  

Effect of botulinum toxin injection combined with Vojta training on lower limb range of motion and fine motor function in children with spastic cerebral palsy

作　　者：张玉新 杨兴鸽[1] 熊华春[2] 李润涛 Zhang Yuxin;Yang Xingge;Xiong Huachun;Li Runtao(Department of Pediatrics,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China;Rehabilitation Center for Children with Cerebral Palsy,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Child Rehabilitation Division,the Third Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China)

机构地区：[1]河南科技大学第一附属医院儿科,洛阳471003 [2]郑州大学第三附属医院小儿脑瘫康复中心,450052 [3]河南科技大学第三附属医院儿童康复科,洛阳471003

出　　处：《中国实用医刊》2021年第23期37-41,共5页Chinese Journal of Practical Medicine

摘　　要：目的探讨肉毒毒素(BTX)注射联合Vojta训练对痉挛型脑性瘫痪(以下简称脑瘫)患儿下肢关节活动度及精细运动功能的影响。方法抽取2018年8月至2020年8月河南科技大学第一附属医院收治的痉挛型脑瘫患儿96例,按照随机数字表法分为对照组和观察组,每组48例。对照组给予Vojta训练,观察组给予BTX注射联合Vojta训练治疗。对比两组治疗前后下肢运动功能[精细运动功能评估表(FMFM)、Peabody精细运动发育量表(PDMS-FM)评分、粗大运动功能量表(GMFM-88)]、下肢痉挛情况[改良Asworth痉挛分级量表(MAS)],以评估两组治疗3个月后的临床疗效。结果观察组临床总有效率(46/48,95.83%)高于对照组(39/48,81.25%),P<0.05。治疗3个月后,两组大腿内收肌角、腘窝角大于治疗前(P<0.05),足背屈角小于治疗前(P<0.05)。治疗3个月后,两组FMFM评分、PDMS-FM评分、GMFM-88评分均高于治疗前(P均<0.05),MAS评分低于治疗前(P<0.05)。结论BTX注射联合Vojta训练可改善下肢关节活动度,提高精细运动功能及粗大运动功能,缓解下肢肌肉痉挛情况,利于患儿康复。Objective To investigate the effect of botulinum toxin(BTX)injection combined with Vojta training on lower limb range of motion and fine motor function in children with spastic cerebral palsy.Methods A total of 96 children with spastic cerebral palsy treated in the First Affiliated Hospital of Henan University of Science and Technology from August 2018 to August 2020 were selected,and they were divided into control group and observation group according to the random number table method,with 48 cases in each group.The control group was given Vojta training,and the observation group was given BTX injection combined with Vojta training.The clinical efficacy of the two groups was evaluated after 3 months of treatment,and the lower limb motor function,including fine motor function measure(FMFM),Peabody developmental motor scale-fine motor(PDMS-FM),gross motor function measure(GMFM-88),lower limb spasm,that is modified Asworth scale(MAS),were compared between the two groups before treatment and after 3 months of treatment.Results The total clinical effective rate of observation group(46/48,95.83%)was higher than that of control group(39/48,81.25%),P<0.05.After 3 months of treatment,the thigh adductor angle and popliteal fossa angle of the two groups were increased,compared with those before treatment(P<0.05),while the foot dorsiflexion angle was reduced,compared with that before treatment(P<0.05).The FMFM score,PDMS-FM score and GMFM-88 score of the two groups were improved,compared with scores before treatment(all P<0.05),while the MAS score was decreased,compared with scores before treatment(P<0.05).Conclusions BTX injection combined with Vojta training therapy can significantly improve lower limb range of motion,effectively improve fine motor function and gross motor function,relieve lower limb muscle spasm,and it is beneficial to the rehabilitation of children.

关 键 词：脑性瘫痪 痉挛型 肉毒毒素 Vojta训练 下肢关节活动度 精细运动功能 

分 类 号：R742.3[医药卫生—神经病学与精神病学]