脊髓损伤后肌痉挛机制与治疗

Mechanism and Treatment of Muscle Spasticity after Spinal Cord Injury(review)

肌痉挛是脊髓损伤所致截瘫患者中常见并发症之一。痉挛常可导致患者肢体酸胀疼痛、关节挛缩、畸形,进而影响行走及在轮椅上保持姿势的能力,并增加异位骨化和骨折的发生率,从而严重影响患者日常生活及康复治疗效果。目前痉挛的治疗方法很多,如药物治疗、运动疗法和物理治疗、神经阻滞疗法、手术治疗等。但单一的治疗方法效果往往不理想,故目前联合应用多种方法来治疗肌痉挛在临床上较受欢迎。本文通过复习文献,就脊髓损伤后肌痉挛的发生机制、症状特点、评定方法进行简要介绍,并针对其临床治疗进行讨论。

Muscle spasticity is one of the common complications in the paraplegic patients who suffer from spinal cord injury （SCI）. Spasticity can result in limbs pain, joint contracture and malformation, then affects walking and the capability of keeping the posture in wheelchairs. Moreover, spasticity can increase the incidence rate of heterotopic ossification and fracture and seriously affects patients＇ daily life and rehabilitation therapy accordingly. There are many kinds of treatments aimed at spasticity at present, such as drug, exercise therapy, physiotherapy, nerve block treatment, operation treatment, and so on. However, single treatment doesn＇t achieve good effect. So it is common that many kinds of treatments are combined to treat spastieity. This article simply introduces the mechanism, symptom and evaluation of the muscle spasticity after SCI and discusses in full the treatment of the muscle spasticity by reviewing recent literatures.