摘要
目的观察不同定位方式下靶肌肉注射不同剂量A型肉毒毒素（BTX-A）治疗儿童痉挛性脑瘫的疗效。方法选择厦门市妇幼保健院儿童神经康复科收治的痉挛性脑瘫患儿120例，分别应用肌电图定位及反向徒手牵拉定位（各60例），再分别按痉挛肌肉局部注射BTX．A剂量（3U／kg、4U／kg及5U／kg）各分为3组（各20例），注射后配合康复训练。随访3个月时患儿疗效，采用粗大运动评价量表（GMFM）评定患儿功能区的运动功能，改良Ashworth痉挛量表评定肌痉挛程度。结果肌电图定位组较反向徒手牵拉定位组治疗后GMFM评分增加和Ashworth分级减轻，差异有统计学意义俨〈0．05），但此两种定位方式下各不同剂量BTX-A组间治疗后GMFM评分和Ashworth分级差异无统计学意义（P〉0．05）。结论在相同有效剂量BTX-A注射情况下，肌电图定位较反向徒手牵拉定位疗效更好。
Objective To observe the clinical effects of different doses of botulinum toxin A （BTX-A） and different lacation ways on children with spastic cerebral palsy. Methods One hundred and twenty patients with BTX-A were employed in our study; these patients were performed locations of electromyography （n=60） and reverse stretching hand （n=60）, and then, they were equally sub-divided into 6 groups, respectively： receiving injection of BTX-A at doses of 3, 4 and 5 U/kg, respectively （n=20）. After injection, they were commenced functional training for 3 months. The gross motor assessment scale （GMFM） was used to assess the motor fimction of functional areas in these children 3 months after the training. The modified Ashworth scale was used to assess the degree of muscle spasticity. Results The scores of GMFM in patients received treatment with location of electromyography increased as compared with those with reverse stretching hand （P〈 0.05）, but the scores had no statistically significances among different doses of BTX-A treatment groups （P〉 0.05）. The Ashwort grade in patients received treatment with location of electromyography alleviated as compared with those with reverse stretching hand （P〈 0.05）, but no statistically significance of grading was noted among different doses of BTX-A treatment groups （P〉0.05）. Conclusion All parameters in patients received treatment with location of electromyography improve better than those with reverse stretching hand after injection of same dose of BTX-A.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2011年第6期630-632,共3页
Chinese Journal of Neuromedicine
关键词
脑性瘫痪
A型肉毒毒素
肌电图定位
徒手定位
Cerebral palsy
Botulinum toxin A
Location with electromyography
Stretching hand
