A型肉毒毒素治疗脑性瘫痪患儿上肢痉挛的疗效分析

Effect of Botulinum Toxin Type A Treatment on Upper Extremity Spasticity in Children with Cerebral Palsy

目的分析A型肉毒毒素(BTX-A)阻滞术缓解脑瘫患儿上肢痉挛的疗效。方法将2004年1月-2011年12月本院收治47例痉挛型偏瘫的脑瘫患儿分为对照组(n=25)和试验组(n=22)。对照组接受常规作业康复训练,试验组在此基础上接受上肢BTX-A阻滞术治疗。根据试验组患儿体重和改良Ashworth评分(MAS)来确定BTX-A剂量,每次用量在30-110 IU之间,平均(50.7±12.7)IU。结果治疗前,两组患儿MAS、简易上肢功能检查法评分均无显著性差异(P>0.05)。试验组治疗后MAS评分明显低于治疗前(P<0.01),且低于对照组(P<0.05)。两组患儿的上肢功能评分均有提高(P<0.05),试验组提高值明显高于对照组(P<0.01)。结论 BTX-A可有效降低脑瘫儿童的上肢肌张力,有助于上肢运动功能的提高。

Objective To analyze the effect of Botulinum toxin-A（BTX-A） block on the upper extremity spasticity in children with cerebral palsy.Methods From January 2004-December 2011,47 children with spastic hemiplegic cerebral palsy were divided into control group（n=25） and experimental group（n=22）.The control group was administered by occupational therapy.The experimental group was treated by BTX-A block in addition.The dose of BTX-A block was identified with the body weight of the child and the Modified Ashworth Scale（MAS）.The dose of injection ranged from 30 IU to 110 IU,average（50.7±12.7） IU.Results There was no significant difference between 2 groups in scores of MAS and Simple Test for Evaluating Hand Function（STEF） before treatment（P〉0.05）.The MAS score reduced in the experimental group 1 month after treatment（P〈0.01）,and was lower in the experimental group than in the control group（P〈0.05）.The score of STEF increased in both groups（P0.05）,and it was higher in the experimental group than in the control group（P0.01）.Conclusion The BTX-A block can decline the upper extremity muscle tone in children with cerebral palsy efficiently,and help to improve the upper extremity function.