Objective To observe the clinical effect of ultrasound-guided botulinum toxin type A (BTX-A) injection combined with routine rehabilitation training on lower limbs dysmyotonia of spastic cerebral palsy children,and to provide evidence for clinical recovery treatment. Methods A total of 42 cases of Cerebral palsy in rehabilitation department of Anhui Provincial Children's Hospital from September 2014 to August 2015 were randomly divided into treatment group with 21 cases and control group with 21 cases,the control group received routine rehabilitation training (exercise therapy and physical therapy),treatment group was treated with BTX-A injection with ultrasound positioning and guidance,and began routine rehabilitation training next day.All patients were evaluated respectively before treatment and one month,three months,six months after treatment,the Modified Ashworth Scale(MAS)and the Gross Motor Function Measure(GMFM) were used as the standard to assess the degree of muscle spasm and gross motor function of lower limbs. Results After one month,three months and six months treatment,the MAS and GMFM scores of two groups were all significantly better than before (P<0.05);At the same time point,compared with the control group,the degrees of spasm and motor function in the treatment group were significantly improved (P<0.05);The MAS score improvement of treatment group between three months and six months after treatment was statistically significant (P>0.05),BTX-A effect had a certain time limit. Conclusion The use of BTX-A with ultrasound in the treatment of spastic cerebral palsy children can relieve the muscular tension,and improve the motor function.
Key words
botulinum toxin /
cerebral palsy /
ultrasonic location /
lower limbs spasticity /
rehabilitation therapy
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] 陈秀洁,李树春.小儿脑性瘫痪的定义、分型和诊断条件[J].中华物理医学与康复杂志,2007,29(5):309-309.
[2] 李晓捷.实用小儿脑性瘫痪康复治疗技术[M].北京:人民卫生出版社,2009:3-7.
[3] 李红,童光磊,张敏,等.503例小儿脑性瘫痪高危因素与干预措施[J].安徽医学,2011,32(1):13-15.
[4] Cosgrove AP,Corry IS,Graham HK.Botulinum toxin in the management of the lower limb in cerebral palsy[J].Dev Med Child Neurol,1994,36(5):386-396.
[5] Liu JJ,Ji SR,Wu WH,et al.The relief effect of botulinum toxin-a for spastic iliopsoas of cerebral palsy on children[J].Eur Rev Med Pharmacol Sci,2014,18(21):3223-3228.
[6] 周陶成,童光磊,张敏,等.脑性瘫痪的临床与MRI表现分析[J].中国儿童保健杂志,2013,21(2):170-173.
[7] 刘建军,纪树荣,胡莹媛,等.酚与肉毒毒素运动点阻滞对脑瘫患儿痉挛的影响[J].中华物理医学与康复杂志,2012,34(2):120-124.
[8] Symeonidis P.The silfverskiold test[J].Foot Ankle Int,2014,35(8):838.
[9] 郭铁成,卫小梅.改良的Ashworth分级应用于上下肢肌张力评估时的比较[J].中国康复,2008,23(5):313-315.
[10] 童光磊,李红,张敏,等.医院内强化康复训练对脑瘫患儿粗大运动功能的影响[J].中国康复理论与实践,2011,17(1):70-71.
[11] 史惟,杨红,黄华玉,等.不同粗大运动功能脑性瘫痪患儿的日常生活活动能力分析[J].中华物理医学与康复杂志,2009,31(2):91-95.
[12] 卓大宏.中国康复医学[M].北京:华夏出版社,1990:707.
[13] Desloovere K,Molenaers G,De Cat J,et al.Motor function following multilevel botulinum toxin type A treatment in children with cerebral palsy[J].Dev Med Child Neurol,2007,49(1):56-61.
[14] 郑玉蔼,徐开寿,李金玲,等.肉毒毒素综合康复治疗与脑瘫患儿蹲伏步态[J].中国康复医学杂志,2010,25(1):83-84.
[15] 颜华,张惠佳,郭春光,等.A型肉毒毒素注射配合功能训练对痉挛型脑瘫尖足畸形及粗大运动功能发育的影响[J].中国康复理论与实践,2010,6(11):1047-1050.
[16] 郭春光,颜华,张惠佳,等.A型肉毒毒素配合综合康复训练治疗痉挛型双瘫脑瘫患儿的疗效观察[J].中国康复医学杂志,2011,26(8):774-776.
[17] 李红丽.小儿脑瘫45例的家庭综合康复训练效果分析[J].中国儿童保健杂志,2012,21(6):555-558.
基金项目:安徽省卫生厅课题(2008B074);安徽省卫生厅中医药管理局课题(2012zy63)
作者简介:张艳娇(1987-),女,河南人,在读硕士研究生,主要研究方向为小儿神经与康复。
通信作者:童光磊,E-mail:Tong704@sina.com
数字出版网址:http://www.cnki.net/kcms/detail/61.1346.R.20160527.1316.016.html
PDF(564 KB)
