A型肉毒毒素注射治疗脑卒中后下肢痉挛30例

Treatment with Botulinal Toxin Type A Injection for Lower Limb Spasticity after Stroke in 30 Cases

目的评价A型肉毒毒素（BTX—A）局部注射治疗脑卒中后下肢痉挛的疗效。方法采用下肢肌肉局部注射BTX—A治疗脑卒中后下肢痉挛30例，每次注射选择3—5块肌肉，每块肌肉的注射剂量50—100U，每次治疗病人接受的注射总量不超过400U，注射后4、12周按Cohen标准分级评定下肢痉挛的改善程度。结果BTX-A局部注射治疗脑卒中后下肢痉挛的总有效率90．0％，显效率86．6％，部分缓解率3．4％。肌肉痉挛1年内接受BTX．A治疗的疗效明显优于1年以上者，二者有效率分别为83．3％和33．3％（P〈0．05）。结论局部注射BTX-A治疗可明显改善脑卒中后下肢痉挛，且脑卒中下肢痉挛尽早接受局部注射BTX-A治疗疗效更佳。

Objective To evaluate the effect of botulinal toxin type A （BOTOX-A） injection in patienes with lower limb spasticity after stroke： Methods A total of 30 patients with lower limb spasficity after stroke were injected with BOTOX-A in the clinical treatment in recent five years. Three to five muscles of lower extremity were selected to receive local intramuscular injection. The dose was between 50 - 100 U for each muscle. All injected dose did not exceed 400 U, and the spasticity degree was evaluated with Cohen＇standard 4 and 12 weeks later after injection. Results The total effective rate was 90.0%, the excellent effective rate was 86.6%, and the partial response rate was 3.4%. The effect of the patients receiving injection within one year afer stroke was much better than that of those receiving injection one year later afer stroke, and the effective rates were 83.3 % and 33.3 %, respectively. Conclusion Local intramuscular injection with BOTOX-A can improve the spasticity degree of lower extremity after stroke obviously, and it may do good to the patients as early as possible after strok.