双侧颈总动脉交感神经网切除术治疗小儿脑瘫的疗效  

Curative effect of bilateral sympathetic nerve network resection of common carotid arteries in the treatment of children with cerebral palsy

作　　者：陈建设 王天恩[1] 李和平[1] CHEN Jianshe;WANG Tianen;LI Heping(The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450044,China)

机构地区：[1]郑州大学第一附属医院,河南郑州450044

出　　处：《中国实用神经疾病杂志》2022年第1期58-62,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河南省科技厅科技攻关项目(编号:172102310138)。

摘　　要：目的探讨颈总动脉交感神经网切除术治疗脑瘫患儿的效果。方法手术组(56例)脑瘫合并流涎患儿行双侧颈总动脉交感神经网切除术,术前、术后观察患儿流涎、颅内血流变化和肢体痉挛变化,设对照组(56例)脑瘫合并流涎患儿常规行针刺等康复训练。结果手术组术后2周行TCD检查,发现患者大脑中动脉的血流速度改善明显,血管阻力指数明显降低,对照组大脑中动脉血流速度改善不明显。随访12个月,手术组流涎总有效率为85.7%,对照组为28.6%,2组比较差异有统计学意义(χ^(2)=37.33,P<0.001);手术组术后患儿肢体综合痉挛指数改善明显,对照组患儿肢体综合痉挛指数改善不明显。结论双侧颈总动脉交感神经网切除术治疗脑瘫患儿流涎有效率高,可改善脑供血及肢体痉挛。Objective To explore the effect of resection of common carotid artery sympathetic nerve net⁃work on children with cerebral palsy.Methods The operation group(56 cases)of children with cerebral palsy and salivation underwent bilateral sympathetic resection of the common carotid artery.The salivation,intracranial blood flow changes and changes in limb spasticity were observed before and after the operation.The control group(56 cases)of children with cerebral palsy and salivation received routine rehabilitation training such as acupuncture.Results TCD was performed 2 weeks after the operation in the operation group.It was found that the blood flow velocity of the middle cerebral artery of the patient improved significantly,while the vascular resistance index was significantly reduced.The blood flow velocity of the middle cerebral artery of the control group did not improve significantly.After 12 months of follow-up,the total effective rate of salivation in the surgical group was 85.7%and the effective rate in the control group was 28.6%.The difference between the two groups was statistically significant(χ^(2)=37.33,P<0.001).The postoperative limb comprehensive spasticity index of children in the operation group improved significantly,while the control group did not improve significantly.Conclusion Bilateral common carotid artery sympathetic resection is effective in the treatment of salivation in children with cerebral palsy,and it can also improve cerebral blood supply and limb spasm.

关 键 词：脑性瘫痪 颈总动脉 交感神经网切除术 流涎 肢体痉挛 

分 类 号：R742.3[医药卫生—神经病学与精神病学]