选择性周围神经部分切断术治疗肢体痉挛的效果

The Efficacy of Selective Peripheral Neurotomy in Treating Spasticity of Limbs

目的探讨选择性周围神经部分切断术治疗肢体痉挛的效果。方法选择2003年8月—2010年10月采用选择性周围神经部分切断术治疗的376例肢体痉挛患者,回顾性分析术后立即与随访期间痉挛程度、肌张力、步态功能的改善、生活质量及并发症情况。结果本组患者平均随访22.4个月,100.0%患者术后立即感觉痉挛状态缓解,随访期间缓解率为93.2%。术后3个月步态功能改善率为76.3%,术后12个月为84.4%。随访期间生活质量提高率为93.2%。术后发生肢体感觉障碍者54例(17.5%),肌力下降者48例(15.6%),随访期间均见好转。随访期间肢体痉挛复发者15例(4.9%)。结论选择性周围神经部分切断术治疗肢体痉挛状态是安全有效的。

Objective To study the efficacy of selective peripheral neurotomy in treating spasticity of limbs. Methods 376 cases treated by selective peripheral neurotomy from August 2003 to November 2010 were selected. They were analyzed retrospectively in spastieity, muscular tension, gait, quality of life and complication right after operation and in follow - up duration. Results With a period of follow up （ mean duration： 22. 4 months）, 100. 0% patients experienced disappearance or notable alleviation of spasticity right after operation, and the alleviation rate in follow - up duration was 93.2%. The improvement rate of motor capacities 3 months after operation was 76. 3%, and was 84. 4% 12 months after operation. A total of 93. 2% cases had better quality of life by follow - up studying. Postoperative complications like dysaesthesias of limbs were found in 54 cases （ 17.5% ）, muscle weakness in 48 cases （ 15.6% ） and recurrence of spasticity in 15 cases （4. 9% ） . Conclusion Selective peripheral neurotomy is a safe and effective surgical method in the treatment of spasticity of limbs.