| 超声弹性成像评价脑卒中偏瘫肢体硬度对痉挛性偏瘫患者预后的影响 |
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| 引用本文： | 樊留博,韩文胜,江莹莹,刘宝华,唐艳.超声弹性成像评价脑卒中偏瘫肢体硬度对痉挛性偏瘫患者预后的影响[J].中华全科医学,2017,15(8):1323. |
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| 作者姓名： | 樊留博 韩文胜 江莹莹 刘宝华 唐艳 |
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| 作者单位： | 1. 温州医科大学附属台州医院康复医学科, 浙江 台州 317000; |
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| 基金项目： | 浙江省医药卫生科技计划项目（2014KYA224；2012KYB238；2010KYB124）；浙江省台州市科技计划项目（14SF03）；浙江省中医药科技计划项目（2011ZB-158） |
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| 摘 要： | 目的 观察基于超声弹性成像技术评价康复治疗前后肢体硬度变化对痉挛性偏瘫患者预后的影响。 方法 应用超声弹性成像检测20例健康人(正常对照组)和2013年7月—2015年12月在浙江省台州医院住院的脑卒中后偏瘫下肢痉挛状态的20例患者(观察组)康复治疗前后下肢股外侧肌、股内侧肌、股直肌及股二头肌的弹性变化,观察康复治疗前和治疗4周后痉挛下肢肌肉弹性变化对预后的影响。 结果 治疗前观察组健侧与患侧纵切应变比较差异有统计学意义(P<0.01),与正常对照组比较,观察组患侧股外侧肌、股内侧肌、股直肌及股二头肌纵切应变均升高(P<0.01);治疗4周后观察组痉挛侧膝关节屈曲状态下股外侧肌、股内侧肌、股直肌及股二头肌纵切应变比治疗前下降(P<0.05),与正常对照组比较,观察组患侧股外侧肌、股内侧肌、股直肌纵切应变下降(P<0.05),但股二头肌纵切应变无明显变化(P>0.05),当膝关节伸展状态下膝关节观察组患侧股外侧肌、股内侧肌、股直肌应变率比检测及正常对照组下降(P<0.05),但患侧股二头肌与正常对照组比较差异无统计学意义(P>0.05)。 结论 超声弹性成像技术可以定量评价脑卒中后痉挛下肢肌张力变化,可作为其康复预后评价方法。
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| 关 键 词： | 痉挛性偏瘫 超声弹性成像 脑卒中 评价 |
| 收稿时间： | 2016-09-28 |
Role of elastosonography in evaluating hemiplegic limb hardness and improving the prognosis of spastic hemiplegia patients |
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| Affiliation: | 1. Department of Rehabilitation Medicine, Taizhou Hospital Affiliated to Wenzhou Medical University, Taizhou, Zhejiang 317000, China |
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| Abstract: | Objective To assess the prognostic effect of the change of hemiplegic limb hardness by using elastosonography in spastic hemiplegia patients. Methods The strain of vastus lateralis, vastus medialis, rectus femoris and biceps femoris in healthy subjects of control group (n=20) and spastic hemiplegia patients of observer group (n=20) before and after the rehabilitation treatment in Taizhou Hospital of Zhejiang Province from July, 2013 to December, 2015 were observed by elastosonography. The influence of the changes of the muscles strain of spastic lower limb after 4 weeks of rehabilitation treatment on the prognosis of patients were evaluated. Results Before the treatment, there was statistically difference in the longitudinal strain between the normal limbs and spastic limbs in the observation group (P < 0. 01), and the longitudinal strain of vastus lateralis, vastus medialis, rectus femoris and biceps femoris of spastic limbs in the observation group were significantly higher than those in the control group (P < 0. 01). After the treatment for 4 weeks, the longitudinal strain of vastus lateralis, vastus medialis, rectus femoris and biceps femoris of spastic limbs at knee flexion was decreased significantly in the observation group (P < 0. 05). When compared with the control group, the longitudinal strain of vastus lateralis, vastus medialis and rectus femoris of spastic limbs decreased (P < 0. 05), but not of biceps femoris (P > 0. 05). At knee extension, the strain ratio of vastus lateralis, vastus medialis and rectus femoris of spastic limbs was lower than that of normal limbs and the control group (P < 0. 05), but the difference between biceps femoris of spastic limbs and the control was not significant (P > 0. 05). Conclusion The elastosonography can qualitatively detect the changes of muscle strain of spastic limbs in stroke patients with spastic hemiplegia, which can be used as the rehabilitation evaluation method for the prognosis of spastic hemiplegia patients. |
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