不同粗大运动功能分级脑性瘫痪患儿选择性脊神经后根切断术疗效分析

Effect of Grade of Gross Motor Function Classification System on Outcome of Selective Posterior Rhizotomy for Children with Cerebral Palsy

目的比较不同粗大运动功能分级脑瘫患儿选择性脊神经后根切断术(SPR)的效果。方法对132例实行SPR手术治疗的患儿按粗大运动功能分级系统(GMFCS)分级,比较各组间疗效。结果不同GMFCS分级脑瘫患儿SPR术后肌张力、粗大运动功能及日常生活活动能力均有明显改善(P<0.01);GMFCSⅠ级者肌张力下降更为明显(P<0.01);GMFCSⅡ级者粗大运动功能改善更为显著(P<0.001);GMFCSⅠ级与GMFCSⅣ级者日常生活活动能力较其余各组改善更为明显(P<0.05),两组之间无显著差异性(P=0.067)。结论 SPR手术对于不同GMFCS分级脑瘫患儿的疗效存在差异。

Objective To observe the outcome of selective posterior rhizotomy （SPR） for cerebral palsy children with different gross mo-tor function before operation. Methods 132 cases accepted SPR were grouped with their grades of Gross Motor Function Classification Sys-tem （GMFCS）, and their outcomes were compared. Results The muscle tension, gross motor function and activities of daily living improvedin all the groups after SPR （P〈0.01）. The muscle tone decreased the most in grade I （P〈0.01）. The gross motor ability improved the most ingrade II（P〈0.001）. The activities of daily living improved the most in grades I and IV （P〈0.05）. Conclusion The outcome of SPR for chil-dren with cerebral palsy is various with the gross motor function before operation.