超声引导下肉毒毒素注射对痉挛型脑瘫儿童运动功能的疗效  

Effect of ultrasound guided botulinum toxin injection on motor function in children with spastic cerebral palsy

作　　者：陈薇 何飞平 黄凌锋 CHEN Wei;HE Fei-Ping;HUANG Ling-Feng(Department of Children Rehabilitation,Chenzhou First People′s Hospital,Chenzhou 423000,Hunan,China)

机构地区：[1]郴州市第一人民医院儿童康复科,湖南郴州423000

出　　处：《吉林医学》2024年第7期1658-1660,共3页Jilin Medical Journal

基　　金：郴州市技术创新引导项目[项目编号:lcyl2021085]。

摘　　要：目的:探究痉挛型脑瘫儿童治疗中超声引导下肉毒毒素注射对患儿运动功能的影响。方法:选取2021年6月~2022年5月郴州市第一人民医院收治的2~6岁双下肢痉挛的脑瘫患儿80例作为研究对象,依据定位技术分为超声引导下肉毒毒素注射组(超声引导组)、徒手肌肉定位肉毒毒素注射组(徒手肌肉组)各40例。统计分析两组踝关节被动屈曲角度、踝背伸角、内收肌角、腘窝角、踝跖屈肌群肌张力、踝跖屈肌群痉挛程度、躯干与下肢运动功能、粗大运动功能、日常生活能力、不良反应发生情况及家长满意度。结果:超声引导组患儿的左侧、右侧踝关节被动屈曲角度均小于徒手肌肉组(P<0.05),踝背伸角、内收肌角、腘窝角均大于徒手肌肉组(P<0.05);超声引导组患儿的改良Ashworth评分(MAS)、综合痉挛量表(CSS)评分均低于徒手肌肉组(P<0.05),MOA评分、GMFM D区与E区评分、MBI评分均高于徒手肌肉组(P<0.05)。超声引导组患儿的不良反应发生率低于徒手肌肉组(χ^(2)=4.507,P<0.05);超声引导组患儿家长满意度高于徒手肌肉组,差异均有统计学意义(χ^(2)=7.440,P<0.05)。结论:超声引导下较徒手肌肉定位法肉毒毒素注射在痉挛型脑瘫儿童治疗中能够改善患儿运动功能。Objective To study the effect of ultrasound-guided botulinum toxin injection on motor function in children with spastic cerebral palsy.Method A total of 80 children with cerebral palsy aged 2 to 6 years old who were hospitalized in the Children′s Rehabilitation Department of Chenzhou First People′s Hospital from June 2021 to May 2022 were selected as the research objects.According to the positioning technique,they were divided into two groups,namely ultrasound-guided botulinum toxin injection group(ultrasound-guided botulinum toxin injection group)and unarmed muscle positioning botulinum toxin injection group(unarmed muscle group),40 cases in each group.The passive flexion Angle of ankle joint,extensor Angle of ankle dorsalis,adductor Angle,popliteal fossa Angle,muscle tension of ankle plantar flexor group,spasm degree of ankle plantar flexor group,motor function of trunk and lower limb,gross motor function,daily living ability,occurrence of adverse reactions and parental satisfaction of the two groups were analyzed statistically.Results The passive flexion angles of left and right ankle joints in the ultrasound-guided group were lower than those in the unarmed muscle group(P<0.05),and the dorsalis extensor Angle of ankle,adductor Angle and popliteal fossa Angle were higher than those in the unarmed muscle group(P<0.05).The MAS score and CSS score of the ultrasound-guided group were lower than those of the bare hand muscle group(P<0.05),while the MOA score,GMFM D zone score,E zone score and MBI score were higher than those of the bare hand muscle group(P<0.05).The incidence of adverse reactions in the ultrasound-guided group was lower than that in the unarmed muscle group(χ^(2)=4.507,P<0.05).The satisfaction of parents in the ultrasound-guided group was higher than that in the bare-hand muscle group(χ^(2)=7.440,P<0.05).Conclusion In the treatment of children with spastic cerebral palsy,ultrasound guided botulinum toxin injection can improve the motor function of children with spastic cerebral palsy more tha

关 键 词：痉挛型脑瘫儿童 徒手肌肉定位法 超声引导下 肉毒毒素注射 运动功能 

分 类 号：R729[医药卫生—儿科]