神经源性骨骼肌病变的肌纤维分段精准牵伸临床研究  

Clinical Study of Muscle Fiber Segmental Precision Extension in Neurogenic Skeletal Muscle Disease

作　　者：周礼贤 张少浩 吴晓东 ZHOU Lixian;ZHANG Shaohao;WU Xiaodong(Shantou Changping Rehabilitation Hospital,Guangdong Shantou 515041;Shantou Central Hospital,Guangdong Shantou 515041)

机构地区：[1]汕头市长平康复医院,广东汕头515041 [2]汕头市中心医院,广东汕头515041

出　　处：《深圳中西医结合杂志》2024年第15期8-12,共5页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：汕头市科技计划医疗卫生自筹经费项目(221124096497222)。

摘　　要：目的:探讨神经源性骨骼肌病变的肌纤维分段精准牵伸治疗的临床效果。方法:选取2022年1月至2023年12月于汕头市长平康复医院治疗的80例神经源性骨骼肌病变患者为研究对象,采用随机数字表法分为基础治疗组和精准牵伸治疗组,各40例。基础治疗组采用常规方法进行牵引治疗,精准牵伸治疗组采用肌纤维分段精准牵伸治疗。比较两组患者的改良Ashworth量表(MAS)评分、Brunnstrom偏瘫运动功能评定、临床痉挛指数(CSI)评分、肌肉羽状角度(PA)、肌纤维长度(FL)、肌纤维厚度(MT)、粗大运动功能测量量表(GMFM88)评分。结果:治疗后2周、4周,精准牵伸治疗组患者MAS评分低于基础治疗组,差异具有统计学意义(P<0.05)。治疗后,精准牵伸治疗组患者上肢、手Brunnstrom偏瘫运动功能评定优于基础治疗组,差异具有统计学意义(P<0.05)。治疗后,精准牵伸治疗组患者CSI的肌张力、阵挛、腱反射评分低于基础治疗组,差异具有统计学意义(P<0.05)。治疗后,精准牵伸治疗组患者PA、MT低于基础治疗组,FL高于基础治疗组,差异具有统计学意义(P<0.05)。治疗后,精准牵伸治疗组患者GMFM88评分高于基础治疗组,差异具有统计学意义(P<0.05)。结论:神经源性骨骼肌病变的肌纤维分段精准牵伸治疗能够加快上肢和手的分期运动康复进程,促进肌肉结构和功能恢复,有效改善关节活动度,缓解肌肉痉挛程度。Objective To investigate the clinical effect of muscle fiber segmental precision extension treatment for neurogenic skeletal muscle disease.Methods A total of 80 patients with neurogenic skeletal muscle disease treated in Shantou Changping Rehabilitation Hospital from January 2022 to December 2023 were selected as the study objects,and were divided into basic treatment group and precision extension treatment group by random number table method,with they 40 cases in each group.The basic treatment group was subjected to conventional traction treatment,and the precision extension treatment group was subjected to muscle fiber segmental precision extension treatment.The score of modified Ashworth scale(MAS),Brunnstrom motor function assessment of hemiplegia,clinical spasticity index(CSI)score,pennation angle(PA),fascicle length(FL),muscular thickness(MT)and Gross Motor Function measure 88 scale(GMFM88)score were compared between the two groups.Results At 2 and 4 weeks after treatment,the scores of MAS in the precision extension treatment group were lower than those in the basic treatment group,and the differences were statistically significant(P<0.05).After treatment,Brunnstrom hemiplegic motor function evaluation of upper limb and hand in the precision extension treatment group were better than those in the basic treatment group,and the differences were statistically significant(P<0.05).After treatment,the CSI scores of muscle tone,clonus and tendon reflex in the precision extension treatment group were lower than those in the basic treatment group,and the differences were statistically significant(P<0.05).After treatment,PA and MT in the precision extension treatment group were lower than those in the basic treatment group,and FL was higher than that in the basic treatment group,the differences were statistically significant(P<0.05).After treatment,the GMFM88 score in the precision extension treatment group was higher than that in the basic treatment group,and the difference was statistically significant(P<0.05).Con

关 键 词：骨骼肌病变 神经源性 肌纤维分段精准牵伸 

分 类 号：R685[医药卫生—骨科学]