系列石膏联合康复训练对痉挛型脑瘫患儿手功能影响的疗效研究

目的:探讨系列石膏对痉挛型脑瘫患儿手功能的影响。方法:选取痉挛型脑瘫偏瘫、四肢瘫患儿40名，随机分为观察组和对照组各20例。2组均采取常规康复治疗方法，观察组在夜间睡眠时联合系列石膏治疗。在治疗前、治疗后3个月、6个月分别评定2组患儿拇指桡侧外展角、上肢技巧质量测试量表(QUEST)A区、B区及儿童功能独立性评定量表(WeeFIM)中自理能力项。结果:2组治疗3及6个月后拇指桡侧外展角与治疗前比较均增加(均P<0.05),且观察组与对照组比较增加更明显(均P<0.05)。观察组治疗3及6个月后、对照组治疗6个月后QUEST评定A区、B区评分与治疗前比较均提高(均P<0.05),且观察组与对照组比较提高更明显(均P<0.05)。2组治疗6个月后WeeFIM量表中自理能力项得分与治疗前比较均提高(P<0.05),且观察组与对照组比较提高更明显(均P<0.05)。结论:系列石膏联合康复训练可明显改善痉挛型脑瘫患儿拇指内收异常姿势，提高手功能及日常生活能力。

Effect of serial casting combined with rehabilitation on hand function of children with spastic cerebral palsy

Objective: To investigate the effect of series casting on upper limb function in children with spastic cere-bral palsy. Methods: All 40 children with spastic cerebral palsy, hemiplegia and quadriplegia were randomly divided into observation group and control group, 20 cases in each group. Both groups were treated with routine rehabilitation therapy, and the observation group was treated with series casting during sleep at night additionally. Before treatment, 3 and 6 months after treatment, the radial abductor angle of thumb, area A and B of quality of upper extremity skills test (QUEST) and self-care items of the functional independence measure for children (WeeFIM) scale were assessed in two groups. Results: The radial abduction angle of thumb in the observation group and the control group increased after 3 and 6 months of treatment as compared with that before treatment (P<0.05), and the increase in observation group was more obvious than that in control group (P<0.05). After 3 and 6 months of treatment in the observation group and 6 months of treatment in the control group, the scores of QUEST evaluation in A and area B were improved as compared with those before treatment (P<0.05), and those the observation group increased more significantly than in the control group (P<0.05). The scores of self-care ability in the WeeFIM scale of the observation group and the control group increased after 6 months of treatment as compared with those before treatment (P<0.05), and those in the observation group increased more significantly than in the control group (P<0.05). Conclusion: Series casting combined with rehabilitation training can obviously improve thumb adduction, hand function and daily living ability of children with spastic cerebral palsy.