胫神经腓肠肌运动分支乙醇溶解术治疗脑卒中后痉挛性垂足的初步研究

Using alcohol gastrocnemius motor branch neurolysis to treat poststroke spastic drop foot-a preliminary study

目的观察胫神经运动神经分支乙醇溶解术对脑卒中患者腓肠肌痉挛和步行功能的影响。方法符合条件的18例患者被收入本研究，应用BTL公司的5000e型电诊断仪在体表探测定位，然后应用无水乙醇进行运动分支神经溶解术。每一点的最大剂量不能超过1ml。结果注射后腓肠肌痉挛的各项指标均立即好转，疗效至少维持6个月；10m步行速度观察，在治疗后1个月有所改善，但没有达到统计学意义，治疗后3个月步行速度显著好于治疗前，疗效至少维持到治疗后6个月。不良反应的发生率很低，且多数为可恢复的。结论腓肠肌胫神经运动分支乙醇溶解术治疗脑卒中后腓肠肌痉挛安全有效，能显著缓解痉挛，改善患者步行功能。

Objective To observe the effect of alcohol motor branch neurolysis of tibial nerve branch on treat gastrocnemius muscle spasticity and walking function in stroke patients. Methods Eighteen stroke patients were included in this study. The first step of motor branch neurolysis is using BTL 5000e electrical stimulator to detect the motor point. Then 100% alcohol was injected into the point. The maximal volume of alcohol for each point is 1 ml. Results After the treatment, spasticity of the gastrocnemius muscle was significantly improved and the effect could last for 6 months. Three months later, the walking velocity increased significantly by using 10 meter walking time test and the improvement in walking ability could last for 6 months. The incidence of side effect was low. Conclusion Alcohol motor branch neurolysis of tibial nerve is safe and effective for treating gastrocnemius muscle spasticity, and for improving walking function in stroke patients.