彩色多普勒超声引导下肉毒毒素A注射治疗脑卒中后肢体痉挛

Color doppler ultrasound guided BTXA injection in treating extremities spasticity after stroke

目的探讨超声引导下局部注射肉毒毒素A(BTXA)治疗脑卒中后肢体痉挛的临床价值。方法选择因中风致上肢或下肢痉挛患者15例(共20患肢),在彩色多普勒超声引导下,将BTXA准确注入到痉挛肌群。注射后佩戴抗痉挛矫形器及常规康复训练。将治疗4周后情况与治疗前进行比较。结果治疗后4周,肌肉痉挛的改善程度(MAS)、上肢运动功能(Fugly-Meyer评分)、与上肢相关的日常生活自理能力(FIM)、步长、步速均比注射前改善(P<0.05)。结论由于定位准确,超声引导下BTXA注射治疗脑卒中后肌痉挛安全可靠,治疗效果明显。

Objective To evaluate the clinical value of ultrasound guided botulinum toxin type A （BTXA） injection in treating extremities spasticity after stroke. Methods 15 patients（20 extremities） with extremity spasticity after stroke were recruited in this clinical study. Guided by color Doppler ultrasonography, BTXA was injected into spastic muscles. Anti-spasticity orthotic devices were used and conventional rehabilitation treatments were conducted after injection. Outcomes were measured at baseline and at 4-week follow-up. Results Significant improvements were observed in the scores of modified Ashworth scale, Fugl-Meyer Assessment （upper limb section）, Motor-Functional Independence Measure-upper limb （mot-FIM-upper limb）, step length, and velocity 4 weeks after treatment （ P 〈 0. 05 ）. Conclusion Color Doppler ultrasound guided BTXA injection was clinically efficacious and safe in treating extremities muscle spasticity after stroke owing to accurately positioning.