肉毒素A注射结合康复训练治疗脑卒中恢复期痉挛性足下垂的临床分析

目的探讨A型肉毒素结合康复训练对脑卒中恢复期痉挛性足下垂的治疗效果。方法脑卒中恢复期患者80例，分为观察组和对照组，每组各40例。对照组采用常规康复治疗，观察组在对照组基础上加用A型肉毒素治疗，治疗后1个月进行评价，运用改良Ashworth量表评定足下垂侧踝关节跖屈时小腿三头肌为主的小腿后主要肌群肌张力大小，改良Lovett肌力测定法评定足下垂侧小腿前主要肌群（主要为胫前肌）肌力，运用改良Barthel指数评定患者日常生活能力，运用Carr-shepherd步行量表评定患者步行能力，运用Berg平衡量表评定患者平衡能力。并测量两组治疗前后踝关节活动度。结果两组均能不同程度上改善脑卒中恢复期足下垂症状，改善脑卒中患者日常生活能力（P〈0．05）。两组治疗后踝关节活动度治疗前均有改善，且观察组总有效率明显高于对照组，差异有统计学意义（P〈0．05）。结论A型肉毒素结合康复治疗对缓解脑卒中恢复期痉挛性足下垂有显著疗效。

Objective To observe the effect of an injection of botulinum toxin type A combined with rehabilitation on the drop foot of patients with stroke. Methods Eighty patients with spasmodic torticollis were randomly divided into a combined treatment group and control group. Both groups were given rehabilitation training.The combined group were given a local.muscular injection of botulinum toxin type A.Both groups were assessed using modified Ashworth scale for the muscle tension of triceps on ankle plantarflexion spasticity on the drop foot, Improved muscle assay Lowett for tibialis anterior muscle＇ s muscle assay, Modified Barthel Index for the quality of life, Carr-shepherd Scale for the walking ablity, Berg Balance Scale for balance ablity, one mouth after the injection, and both group＇ s ankle range of motion were measured. Results The two groups showed improvement to different extents after treatment, improve post-stroke foot drop and promote the recovery of function, improved quality of life.and both improve the ankle range of motion, while the efficacy in the treatment group was superior to that in the control group （P〈0.05） .Conclusions Botulinum toxin type A combined with rehabilitation can significantly improve post-stroke foot drop and promote the recovery of function.