A型肉毒毒素用于治疗痉挛型脑性瘫痪的临床研究

目的:探讨A型肉毒毒素注射治疗痉挛型脑性瘫痪儿童肌肉痉挛的疗效。方法:选择痉挛型脑性瘫痪儿童200例,A型肉毒毒素注射组(注射组)和单纯康复治疗组(对照组)各100例。其中注射组将A型肉毒毒素准确注射到患儿痉挛肌群,注射后次日开始进行康复训练(共12周)。所有病例在治疗前及治疗后1周、2周、4周、8周、12周分别采用改良Ashworth量表、粗大运动功能量表及医师等级评价量表进行相关评价。结果:注射组在注射后各观察时点肌肉痉挛改善程度和运动功能评分均优于注射前(P<0.05),注射组治疗效果明显优于对照组。结论:A型肉毒毒素注射治疗可以快速、有效地缓解痉挛;注射治疗结合康复训练相较于单纯康复训练,更有助于提高运动功能、缩短治疗时间。

A clinical study on botulinum toxin A injection for spastic cerebral palsy

Abstract Objective: To evaluate the clinical value of botulinum toxin A injection for spastic cerebral palsy(CP) children. Method: Two hundred patients children with spastic cerebral palsy were divided into 2 groups, a group treated with botulinum toxin A injection (injection group) treated and a group treated with rehabilitation treatment(control group). For injection group, botulinum toxin A was accurately injected into the spasticity muscle of CP children, and 24h after injection children received continuous rehabilitation training for 12 weeks. For control group, CP children received rehabilitation training only. Before treatment and 1 week, 2 weeks, 4 weeks, 8 weeks and 12 weeks after treatment, muscle spasticity and movement function were evaluated by modified Ashworth scale, gross motor function measure and physician rating scale. Result: The improvement of muscle spasticity and scores of movement function in injection group were better than before treatment. The therapeutic effects in injection group were better than that in control group. Conclusion: Botulinum toxin A injection could reduce CP children's spasticity quickly and effectively. Compared with simple rehabilitation training, botulinum toxin A injection in combination with rehabilitation training could improve movement function and shorten the period of treatment significantly.