SPR治疗痉挛性脑瘫患者的远期疗效分析

Long Term Effect Analysis of Surgery in the Treatment of Spastic Cerebral Palsy after SPR

目的:探讨选择性脊神经后根切断术(SPR)治疗的痉挛型脑瘫患者的远期疗效及安全性。方法:回顾性研究方法,对行SPR术治疗的30例脑瘫患者的临床资料进行回顾性分析,评价患者术后10年以上的肌张力、肌力、下肢运动功能、生活自理能力及相关术后远期影响。结果:30例患者中肌力改善并长期维持30人。肌张力下降至正常或2级并长期维持30人。尖足、踝阵挛、交叉腿消失并长期维持30人。膝反射亢进消除30人,babinski征转阴率56.7%。下肢功能系列改善率100%,14例术前有残余尿,术后12例残尿消失,长期无复发。复查腰椎X光片22例,其中19例出现不同程度的腰椎改变。结论:SPR可长期有效的解除痉挛性脑性瘫痪异常增高的肌张力和踝阵挛、尖足、交叉腿现象,病理征现象并能一直维持,结合康复训练,可改善患者生活自理能力。

Objective： To investigate the selective posterior rhizotomy （SPR） of patients with spastic cerebral palsy long-term efficacy and safety of treatment. Methods：A retrospective study method, on the SPR operation for treatment of 30 cases of patients with cerebral palsy were retrospectively analyzed clinical data, long term effect evaluation of patients after 10 years, muscle tension, muscle strength of lower limb motor function, self-care ability and postoperative.Results：30 patients in improvement of muscle strength and long-term maintenance 30. Muscle tension decreased to normal or level 2 and long-term maintenance 30. Pointed foot, ankle clonus, cross legs disappeared and maintained for 30 people long. Knee jerk hyperreflexia eliminate 30 negative rate is 56.7%, Babinski syndrome. The function of the lower limbs series improvement rate 100%, 14 cases of residual urine before operation, 12 cases of postoperative residual urine disappeared without recurrence, long-term. Review of lumbar X ray film in 22 cases, including 19 cases of lumbar change in different degree.Conclusion：SPR can be a long-term effective relieve spastic cerebral palsy muscle tension and ankle clonus, pointed foot, cross leg phenomenon of abnormally increased, pathological syndrome phenomena and has been maintained, combined with rehabilitation training, can improve the patient＇s self-care ability.