超声联合电刺激定位注射A型肉毒毒素对上肢痉挛的疗效观察  

Efficacy observation of treating upper limb spasticity by injecting botulinum toxin-A guided by ultrasound combined with electrical stimulation

作　　者：陈法言 王庆路 CHEN Fa-yan;WANG Qing-lu(Department of Rehabilitation Medicine,Affilicated BenQ Medical Center of Nanjing Medical University,Nanjing 210019,China)

机构地区：[1]南京医科大学附属明基医院康复医学科,210019

出　　处：《中国实用医药》2022年第20期129-132,共4页China Practical Medicine

摘　　要：目的观察超声联合电刺激定位注射A型肉毒毒素对上肢痉挛的疗效。方法50例脑卒中后患侧上肢痉挛患者,采用超声联合电刺激定位进行痉挛肌A型肉毒毒素注射。比较患者治疗前、治疗后1周改良Ashworth量表(MAS)评分、主动关节活动度(AROM)、视觉模拟评分(VAS)评分。结果50例患者治疗后1周屈肘、屈腕、屈指、前臂旋前MAS评分以及VAS评分分别为(1.50±0.32)、(1.17±0.68)、(1.33±0.41)、(1.08±0.66)、(2.33±1.63)分,均低于治疗前的(2.50±0.55)、(2.33±0.52)、(2.17±0.41)、(2.33±0.52)、(4.33±1.21)分;伸肘、伸腕、伸中指近端指间关节、伸中指远端指间关节、前臂旋后AROM分别为(46.67±7.53)、(-11.67±6.06)、(45.00±8.37)、(24.17±8.61)、(-15.83±8.61)°,均优于治疗前的(55.83±5.85)、(-19.17±4.92)、(55.00±6.32)、(35.00±6.32)、(-25.83±5.85)°,差异均具有统计学意义(P<0.05)。结论超声联合电刺激定位注射A型肉毒毒素对上肢痉挛的治疗准确、安全、有效。Objective To observe the efficacy of botulinum toxin-A injection guided by ultrasound with combination of electrical stimulation on upper limb spasticity.Methods 50 patients with upper limb spasm on the affected side after stroke were treated with botulinum toxin-A injection in spastic muscles guided by ultrasound combined with electrical stimulation.The scores of modified Ashworth scale(MAS),active range of motion(AROM)and visual analogue scale(VAS)were compared before and after treatment.Results 1 week after treatment,the MAS score of elbow flexion,wrist flexion,finger flexion,forearm pronation and VAS score were(1.50±0.32),(1.17±0.68),(1.33±0.41),(1.08±0.66),and(2.33±1.63)points,which were lower than(2.50±0.55),(2.33±0.52),(2.17±0.41),(2.33±0.52),and(4.33±1.21)points before treatment;the AROM of elbow extension,wrist extension,proximal interphalangeal joint extension of middle finger,distal interphalangeal joint extension of middle finger,and supination of forearm were(46.67±7.53),(-11.67±6.06),(45.00±8.37),(24.17±8.61),and(-15.83±8.61)°,which were better than(55.83±5.85),(-19.17±4.92),(55.00±6.32),(35.00±6.32),and(-25.83±5.85)°before treatment;all the differences were statistically significant(P<0.05).Conclusion Botulinum toxin-A injection guided by ultrasound combined with electrical stimulation is a accurate,safe and effective approach to treat upper limb spasticity.

关 键 词：上肢痉挛 A型肉毒毒素 超声 电刺激 

分 类 号：R746[医药卫生—神经病学与精神病学]