A型肉毒毒素对不同时期脑卒中后肢体痉挛的疗效分析  

Therapeutic effect of botulinum toxin type A on limb spasticity after stroke at different stages

作　　者：王少华[1] 张萌 刘立夏[3] Wang Shaohua;Zhang Meng;Liu Lixia(Department of Rehabilitation,Anyang District Hospital in Puyang City,Anyang 455000,China;Department of External MedicineⅢ,Anyang Traditional Chinese Medicine Hospital,Anyang 455000,China;Henan Nursing Vocational College,Anyang 455000,China)

机构地区：[1]濮阳市安阳地区医院康复科,安阳455000 [2]安阳市中医院外三科,安阳455000 [3]河南护理职业学院,安阳455000

出　　处：《中国实用医刊》2024年第3期109-112,共4页Chinese Journal of Practical Medicine

基　　金：河南省医学教育研究项目(Wjlx2022270)。

摘　　要：目的分析A型肉毒毒素对不同时期脑卒中后肢体痉挛的治疗效果。方法非随机对照研究。抽取2018年9月至2023年6月濮阳市安阳地区医院收治的96例脑卒中后痉挛性偏瘫患者作为研究对象,按照痉挛发病时期分为早期组、中期组、晚期组,每组32例。患者入院后均采用A型肉毒毒素注射治疗。比较三组患者治疗前后肢体痉挛程度、步行功能及生活质量的变化。结果治疗前,三组Ashworth痉挛分级比较差异未见统计学意义(P>0.05);治疗2~8周后,三组Ashworth痉挛分级均呈下降趋势,但三组间比较差异未见统计学意义(P>0.05)。治疗前,三组6 min步行试验(6WMT)、功能性步行量表评分比较差异未见统计学意义(P>0.05);治疗2周后,三组6WMT、功能性步行量表评分均有所好转,至治疗后4、8周,早期组步行速度最快,功能性步行量表评分最高,与其他两组比较差异有统计学意义(P<0.05)。结论A型肉毒毒素对不同时期脑卒中后肢体痉挛均有一定的治疗效果,尤其是在脑卒中后肢体痉挛发生6个月内完成注射将达到最佳成效。Objective To analyze the effect of botulinum toxin type A on limb spasticity after stroke at different stages.Methods A total of 96 patients with spastic hemiplegia after stroke admitted to Anyang District Hospital in Puyang City from September 2018 to June 2023 were selected as the study objects of the non-randomized clinical controlled study.And the patients were divided into early group,middle group and late group according to onset periods of spasm,with 32 cases in each group.All patients were treated with botulinum toxin A injection after admission.The changes of limb spasm degree,walking function and activities of daily life in the three groups were compared before and after treatment.Results Before treatment,there was no statistically significant difference in Ashworth spasm grade among the three groups(P>0.05).After 2 to 8 weeks of treatment,Ashworth spasm grade decreased in all three groups,but there was no significant difference among the three groups(P>0.05).Before treatment,there were no significant differences in 6-minute walking test(6WMT)distance and functional walking scale scores among the three groups(P>0.05).After 2 weeks of treatment,the 6WMT distance and functional walking scale score in the three groups were improved(P<0.05).After 4 and 8 weeks of treatment,the early group had the fastest walking speed and the highest functional walking scale score,with statistically significant differences in comparison with the other two groups(P<0.05).Conclusions Botulinum toxin type A has a certain therapeutic effect on limb spasticity after stroke in different stages,especially,completing botulinum toxin type A injection within 6 months after onset of post-stroke limb spasticity can achieve the optimum effect.

关 键 词：A型肉毒毒素 不同时期 脑卒中 肢体痉挛 

分 类 号：R743.3[医药卫生—神经病学与精神病学]