康复训练对A型肉毒毒素治疗痉挛型脑瘫长期疗效的影响

Effect of Rehabilitation on Long-term Efficacy of Botulinum Toxin Type A on Spastic Cerebral Palsy

目的探讨康复训练对A型肉毒毒素(BTX-A)阻滞术缓解脑瘫患儿痉挛长期疗效的影响。方法 230例痉挛型脑瘫患儿接受BTX-A阻滞术治疗,根据患儿体重和修改的Ashworth量表(MAS)评分确定BTX-A剂量。A组每天进行康复训练2 h以上,B组进行康复训练2 h以下或无训练。1年后评定其粗大运动功能(GMFM)。结果 A、B两组患儿的年龄、体重、术前的MAS、GM-FM均无显著性差异(P>0.05),两组患儿肉毒毒素作用时间无显著性差异(P>0.05)。术后1年两组GMFM均较术前提高(P<0.05)。A组GMFM分数提高明显多于B组(P<0.01)。结论 BTX-A阻滞术后有肯定的长期疗效。阻滞术后开展康复训练有助于患儿粗大运动功能的提高。

Objective To investigate the long-term efficacy of Botulinum toxin type A（BTX-A） on spasticity in cerebral palsy,and the effect of rehabilitation on it.Methods 230 children with spastic cerebral palsy were treated with BTX-A block.The dose of BTX-A was identified with the weight of the children and the Modified Ashworth Scale（MAS）.They were divided into group A who exercised more than 2 h/d,and group B who exercised less than 2 h/d or not.They were assessed with Gross Motor Function Measure（GMFM） 1 year after treatment.Results There was no significant difference between group A and B with ages,weight,MAS,GMFM before block（P〉0.05）,nor with BTX-A effect time（P〉0.05）.The GMFM improved significantly in both group A and B 1 year after block（P〉0.05）,and it improved more in group A than group B（P〈0.01）.Conclusion The long-term efficacy of BTX-A block is positive.The rehabilitation training after block can help children to improve their gross motor function.