A型肉毒毒素注射配合综合康复训练治疗痉挛型偏瘫型脑瘫患儿临床分析

目的探讨A型肉毒毒素治疗痉挛型偏瘫型脑瘫患儿的临床疗效。方法选择痉挛型偏瘫型脑瘫儿童40例,随机分为A型肉毒毒素治疗组20例和单纯康复治疗组（对照组）20例。治疗组将A型肉毒毒素注射到患儿腘伸肌群和小腿三头肌群,注射后第2天开始进行康复训练（共6个月）。所有患者治疗前及治疗后2周、1个月、3个月、6个月进行腘窝角和足背屈角角度的测量、改良的Ashworth量表、粗大运动功能分级量表进行评价。结果治疗组的腘伸肌群和小腿三头肌群肌张力和粗大运动功能评分均比注射前改善明显（P〈0.05）,治疗效果明显优于对照组（P〈0.01）。结论 A型肉毒素配合康复治疗可以有效降低患儿患侧的肌张力,有助于提高运动功能,缩短治疗时间。

Clinical analysis of BTX-A injection combined with comprehensive rehabilitation training for spastic hemiplegia

Objective To investigate the clinical value of BTX-A injection for spastic hemiplegia children.Methods Forty children with spastic hemiplegia were selected ,and randonmly divided into 2 groups.The control group accepted rehabilitation training ,and the treatment group received BTX-A injection and rehabilitation training.For treatment group ,BTX-A was injected into the spasticity muscle ,24 h after injection children received rehabilitation training for six months ;Control group only accepted physical treatment.Before treatment and 2 weeks ,1 month ,3 months ,6 months ,popliteal angle and the angle of dorsiflexion of foot were measured ;they were assessed with modified Ashworth scale （MAS） ,gross motor funcition measure （GMFM-88）.Results The improvement of MAS and GMFM were better in the treatment group after treatment （P〈0.05） and the effectiveness of the treatment group was better than that of the control group （P〈 0.05）.Conclusion BTX-A injection combined with rehabilitation training can reduce muscle tension and improve gross motor function of children with spastic hemi-plegia ,and shorten the period of treatment.