肉毒杆菌毒素A注射治疗小儿脑性瘫痪的临床疗效观察及护理体会

Clinical Effect of Botulinum Toxin A Injection on Children Cerebral Palsy and Nursing Experience

目的观察肉毒杆菌毒素A(BTX-A)注射治疗小儿痉挛性下肢瘫的临床效果。方法将30例痉挛型下肢瘫患儿随机分为2组,一组采用常规康复训练、射频法、高压氧及静脉用营养脑细胞药物治疗(常规治疗组);另一组在常规疗法的基础上加用BTX-A进行痉挛肌肉局部注射治疗(综合治疗组),以腘窝角、足背屈角及外展角作为观察指标,评价治疗前、后及两组患者间的疗效差异。结果两组患者治疗前、后各指标间差异均有显著性意义(P<0·05),且综合治疗组较常规治疗组疗效好(P<0·05)。结论BTX-A注射治疗可显著改善痉挛性脑瘫儿童的肌张力及肢体异常姿势,与其他康复治疗间有协同作用,是一种安全而有效的脑瘫辅助治疗手段。

Objective To observe the clinical effects of Botulinum toxin A （BTX -A） injection on children with spastic diplegia. Methods Thirty children with spastic paraparesis were randomly divided into two groups： routine treatment group and multiple treatment group. The children in routine treatment group were treated with conventional rehabilitation training, radio frequency, hyperbararic oxygenation, and transfusion of cerebrocellular nutrients. While in multiple treatment group the children were treated with both BTX - A injection into local spasmodic muscle and routine treatment. The indexes of popliteal fossa angle, foot dorsiflection angle and abduction angle were used for evaluating the difference of effects between this two groups. Results All indexes in both groups were improved in different grades after treatment, and there is a significant difference （ P 〈 0.05 ）. The effect of multiple treatment group was better than that of routine treatment group （ P 〈 0.05）. Conclusion BTX - A injection can remarkably improve muscular tension and abnormal posture in children with spastic cerebral palsy, which is of synergistic effect to other rehabilitations, being a safe and effective supplementary treatment in cerebral palsy rehabilitation.