超声弹性成像评估肉毒毒素治疗脑卒中后 前臂屈肌痉挛的应用价值  

The application effects of ultrasound elastography in evaluating the curative effects of botulinum toxin A injection on forearm flexor spasm after cerebral stroke

作　　者：夏雪 杨晓青 薛梅 杨春燕 XIA Xue;YANG Xiaoqing;XUE Mei(Deparrtment of Ultrasound Diagnosis,,Shijiazhuang People’s Hospital,Hebei,Shijiazhuang,050013,China)

机构地区：[1]河北省石家庄市人民医院超声科,050013

出　　处：《河北医药》2022年第17期2622-2625,2629,共5页Hebei Medical Journal

基　　金：石家庄市科学技术研究与发展计划项目(编号:191460373)。

摘　　要：目的研究超声弹性成像(UE)技术评估A型肉毒毒素(BTXA)注射治疗脑卒中(CS)后前臂屈肌痉挛效果的应用价值。方法选取2019至2020年收治的92例CS患者,根据随机数字表法分为对照组和观察组,每组46例。2组均实施常规康复治疗,观察组另实施超声引导下BTXA注射治疗,观察2组治疗前、治疗后2、4周患侧前臂屈肌群中桡侧腕屈肌的纤维长度(FL)、肌纤维厚度(MT)、肌肉弹性剪切模量(G)、改良Ashworth量表(MAS)分级、痉挛指数(CSI),比较2组治疗效果。结果治疗后2周、4周,观察组G、肌肉横截面积明显低于对照组,而FL明显高于对照组,差异有统计学意义(P<0.05)。治疗后2周,2组MAS分级明显低于治疗前(P<0.05),2组MAS分级比较,差异无统计学意义(P>0.05);治疗后4周,2组MAS分级明显低于治疗前(P<0.05),对照组MAS分级与治疗后2周比较差异无统计学意义(P>0.05),观察组MAS分级明显低于治疗后2周(P<0.05),观察组MAS分级明显低于对照组(P<0.05)。治疗前,2组肌张力、腱反射、阵挛评分及CSI总分比较差异无统计学意义(P>0.05);治疗后2周、4周,2组肌张力、腱反射、阵挛评分及CSI总分明显降低,观察组肌张力、腱反射、阵挛评分及CSI总分明显低于对照组,差异有统计学意义(P<0.05)。观察组治疗显效率明显高于对照组,差异有统计学意义(P<0.05)。结论在UE的评估下,BTXA注射治疗可有效缓解CS患者前臂屈肌痉挛症状,改善肌肉功能,临床应用价值高。Objective To investigate the application effects of ultrasound elastography(UE)in evaluating the curative effects of botulinum toxin A(BTXA)injection on forearm flexor spasm after cerebral stroke(CS).Methods A total of 92 patients with CS who were treated from January 2019 to December 2020 were enrolled in the study,who were randomly divided into two groups,with 46 cases in each group.The patients in both groups were given routine rehabilitation treatment,on that baisi,thepatients in observation group were treated by ultrasound-guided BTXA injection.The therapeutic effects,MAS grading and CSI were observed and compared between the two groups.Results At 2w and 4w after treatment,the muscle tone shear modulus(G),cross sectional area and clinical spasticity index(CSI)scores in observation group were significantly smaller/lower than those in control group,however,the fiber length(FL)was significantly larger than that in control group(P<0.05).At 4w after treatment,the modified Ashworth Scale(MAS)classification in observation group was significantly lower than that in control group(P<0.05).The effective rate in observation group was significantly higher than that in control group(P<0.05).Conclusion Based on the evaluation of UE,BTXA injection can effectively relieve the forearm flexor spasm and improve muscle function of patients with CS,therefore,it is of higher cinical application value.

关 键 词：脑卒中 超声弹性成像技术 A型肉毒毒素 前臂屈肌痉挛 

分 类 号：R445.1[医药卫生—影像医学与核医学]