肉毒毒素结合康复训练治疗痉挛型脑瘫

目的:观察局部肌肉注射A型肉毒毒素(BTX-A)治疗痉挛型脑瘫的疗效。方法:83例痉挛型脑瘫患儿分为观察组53例和对照组30例,均采用BTX-A局部肌肉注射和推拿治疗;观察组同时结合系统的康复训练等。治疗前后均以改良阿氏量表(MAS)评分肌张力,运动评价量表(PRS)评定运动功能。结果:治疗3个月后与治疗前比较2组MAS评分均明显下降,PRS评分明显升高(均P<0.05);与对照组比较观察组表现更明显(P<0.05)。结论:局部肌肉注射BTX-A结合系统康复训练能有效缓解痉挛型脑瘫患儿的肌张力,改善步态、提高行走能力。

A Clinical Research on Local Intramuscular Injection of Botulinum Toxin A and Rehabilitation Training in the Treatment of Spastic Cerebral Palsy

Objective:To study the curative effectiveness of botulinum toxin A(BTX-A) intramuscular injection and rehabilitation training in the treatment of spastic cerebral palsy.Methods Eighty-three patients with spastic cerebral palsy were divided into following two groups:the treatment group received local intramuscular injection of BTX-A,massage therapy and rehabilitation training,and the control group receiving only local intramuscular injection of BTX-A and massage therapy.The muscle tone was assessed with the Modified Ashworth Scale(MAS) and range of motion with Physical Rating Scale(PRS).The muscle tone and PRS were observed before and 4 weeks after therapy.The data were analyzed.Results After treatment for 3 months,MAS scores were significantly decreased and PRS scores significantly increased in both two group as compared with those before therapy(both P<0.05).The muscle tone fraction of PRS in both two groups was significantly improved(P<0.05).There was significant difference between treatment group and control groups(P<0.05).Conclusion:Local intramuscular injection of BTX-A in combination with massage therapy and rehabilitation training can effectively decrease the muscle tone of the children with spastic cerebral palsy and significantly improve gait and walking ability.