A型肉毒毒素治疗脑血管病后肌痉挛的疗效观察

Therapeutic effect of botulinum toxin A to muscle spasticity after cerebral vascular diseases

目的 观察 A型肉毒毒素 ( BTX- A)治疗脑血管病 ( CVD)后肌痉挛的疗效和安全性。方法 使用国产 BTX- A局部注射治疗 4 2例 CVD后肌痉挛患者。注射剂量、位点数根据受累肌肉大小、多少及痉挛程度采取个体化原则 ,注射部位按照解剖学体表标志定位。观察注射前后肢体肌力、肌张力 (改良 Ashworth评分 )及功能等改变。结果 注射后患肢肌张力改良 Ashworth评分、步速、步长 ,踝关节活动度均较治疗前明显改善 ( P<0 .0 1、P<0 .0 1、P<0 .0 5、P<0 .0 1) ;注射后 12 .12 % ( 4 /3 3 )患者出现轻度下肢无力 ,持续 4～ 6周后自行好转。结论 BTX- A局部注射是治疗 CVD后肌痉挛的一种安全、简便的有效方法 。

Objective To observe the therapeutic efficacy and the safety on botulinum toxin A (BTX A) to muscle spasticity after cerebral vascular diseases (CVD).Methods 42 patients with muscle spasticity after CVD were injected with Chinese type A botulinum toxin(CBTX A).The dosage and number of injection point were determined according to the affected musclar size and the degree of muscle spasms.The injection sites were determined according to anatomy surface landmarks for location.The myodynamia of the limbs,the muscular tone (modified Ashworth score) and the function before and after injection were observed.Results The muscular tone modified Ashworth score,pace velocity,stride length and ankle ROM were remarkbly progressive after injection(P< 0.01 ,P< 0.01 ,P< 0.05 ,P< 0.01 );12.12%(4/33) of patients after injection showed mild leg weakness for 4~6 weeks.Conclusion The local injection with BTX A for the muscle spasticity after CVD was a safe,simple,effective method,the side effect was a little.