A型肉毒素局部注射对脑卒中后痉挛性上肢功能障碍的影响

目的评估A型肉毒毒素(BTX-A)局部注射对脑卒中后痉挛性腕及手功能障碍的影响。方法 36例患者于治疗前及治疗后1周、4周、8周和12周应用改良Ashworth量表(MAS)、Carroll上肢功能试验(UEFT)、肢体静息位置、疼痛视觉模拟评分(VAS)、改良Barthel指数(MBI)、上肢3个运动任务(清洗偏瘫侧的手掌、剪患侧手指甲、将患侧的手臂伸进袖子)中遇到的困难进行评估。结果治疗后,MAS、VAS、UEFT评分和3个上肢任务完成情况均有改善(P<0.05),改善于注射后1周出现,并至少维持12周。MBI与治疗前比较无显著性差异(P>0.05)。结论 BTX-A局部注射可以改善脑卒中后痉挛性上肢功能障碍,减轻疼痛。

Effect of Botulinum Toxin A on Spastic Upper Limbs Dysfunction Post Stroke

Objective To evaluate the effects of botulinum toxin type A(BTX-A) on spasticity of wrist and hand post stroke.Methods 36 patients accepted BTX-A injection were assessed with modified Ashworth scale(MAS),Upper Extremities Functional Test(UEFT),limbs position at rest,Visual Analogous Scale(VAS) for pain,modified Barthel Index(MBI),and difficulties encountered during 3 upper limb motor tasks: cleaning the affected palm,cutting the affected fingernails,putting the affected arm into the sleeve,before and 2,4,and 12 weeks after treatment.Results The scores of MAS,VAS,UEFT and accomplishment of those tasks improved after treatment(P<0.05),from 1 week to 12 weeks.No significant improvement was observed in MBI(P>0.05).Conclusion Local BTX-A injection can reduce the spasticity and pain,and improve function of upper limbs for stroke patients.