多点靶肌注射与非多点靶肌注射A型肉毒毒素对小儿痉挛型脑性瘫痪临床效果比较

目的 对比分析多点靶肌注射与非多点靶肌注射A型肉毒毒素对小儿痉挛型脑性瘫痪的临床效果。方法 选择2013年3月-2016年3月在河南中医药大学第一附属医院进行诊治的小儿痉挛型脑性瘫痪患者118例，随机分为两组，每组各59例。对照组采用非多点靶肌注射A型肉毒毒素治疗，观察组采用多点靶肌注射A型肉毒毒素治疗，比较两组治疗前、治疗1个月、治疗3个月、治疗6个月以及治疗12个月的改良Ashworth评分、CSS评分和GMFM评分。结果 治疗后两组的改良Ashworth评分均明显降低，同组治疗前后比较差异有统计学意义（P < 0.05）；治疗12个月后比较，观察组明显低于对照组，差异有统计学意义（P < 0.05）。治疗后两组的CSS评分均明显降低，同组治疗前后比较差异有统计学意义（P < 0.05）；但两组间无明显差异。治疗后两组的GMFM评分均明显升高，同组治疗前后比较差异有统计学意义（P < 0.05）；但两组间无明显差异。结论 多点靶肌注射与非多点靶肌注射A型肉毒毒素对小儿痉挛型脑性瘫痪均具有显著的临床治疗效果，且多点靶肌注射Ashworth评分优于非多点靶肌注射，更加有效缓解患儿的肢体痉挛程度，改善粗大运动能力。

Comparison of clinical effects of multipoint injection and nonmultipoint injection of Botulinum Toxin type A in children with spastic cerebral palsy

Objective To explore the clinical effects of multipoint injection and nonmultipoint injection of Botulinum Toxin type A in children with spastic cerebral palsy. Methods 118 children with spastic cerebral palsy were enrolled in our hospital from March 2013 to March 2016, and were randomly divided into two groups (n= 59). The control group was treated with nonmultipoint injection of Botulinum Toxin type A, the observation group using multipoint injection of Botulinum Toxin type A. The improved Ashworth score, CSS score, and GMFM score were compared between the two groups before treatment, 1 month after treatment, 3 months after treatment, 6 months of treatment, and 12 months of treatment. Results The improved Ashworth scores of the two groups were significantly lower (P < 0.05), there was significant difference between the two groups after 12 months of treatment. The scores of CSS in the two groups were significantly decreased (P < 0.05), but there was no significant difference between the two groups. The scores of GMFM in both groups were significantly increased (P < 0.05), but there was no significant difference between the two groups. Conclusion Multipoint injection and nonmultipoint injection of Botulinum Toxin type A on children with spastic cerebral palsy have significant clinical treatment effect, Ashworth scores of multipoint injection is better then nonmultipoint injection, can effectively alleviate the degree of limb spasm in children to improve the ability to exercise.