体外冲击波对痉挛性脑瘫患儿小腿三头肌痉挛的疗效和安全性分析

Efficacy and Safety of Extracorporeal Shock Wave on Calf Triceps Tendon in Children with Spastic Cerebral Palsy

目的探讨体外冲击波对痉挛性脑瘫患儿小腿三头肌痉挛的疗效和安全性。方法方便选取2016年1月—2017年12月期间该院接收的80例痉挛性脑性瘫痪小腿三头肌痉挛患儿进行研究,应用随机数表法分为观察组和对照组,各40例。其中对照组进行一般性康复治疗,观察组采用体外冲击波进行治疗。比较分析两组患儿治疗疗效情况及两种方法的安全性。结果两组患儿治疗后,观察组患儿的GMFM评分、足底支撑面积、步长和步速分别为(25.83±1.76)分、(63.42±3.21)cm2、(37.24±0.02)cm、(45.23±0.12)cm/s,均高于对照组的(20.58±1.24)分、(52.46±2.83)cm2、(33.53±0.02)cm、(36.53±0.10)cm/s,差异有统计学意义(t=15.423、16.198、829.581、352.253,P<0.05),而MAS评分和足底压力分别为(2.43±0.32)分、(79.34±3.76)N/cm2,明显低于对照组的(3.04±0.41)分、(86.23±4.13)N/cm2(t=7.418、7.802,P<0.05)。且观察组出现1例肌肉麻木患儿,其总并发症发生率为2.50%,明显低于对照组的25.00%,差异有统计学意义(χ~2=8.538,P<0.05)。结论该院应用体外冲击波对痉挛性脑瘫患儿小腿三头肌痉挛进行治疗,其疗效极佳,减轻其痉挛,提高其运动能力,并使足底支撑面积增大,且安全性较高,值得在临床大力推广。

Objective To investigate the efficacy and safety of extracorporeal shock wave in the treatment of calf triceps tendon in children with spastic cerebral palsy. Methods 80 children with spastic cerebral palsy calf triceps tendon received from the hospital from January 2016 to December 2017 were convenient selected and enrolled. The patients were divided into observation group and control group by using random number table method, 40 cases each. The control group was treated with general rehabilitation, and the observation group was treated with extracorporeal shock wave. The therapeutic effects of the two groups of children and the safety of the two methods were compared and analyzed. Results After treatment, the GMFM score, plantar support area, step size and pace of the observation group were （25.83±1.76）points, （63.42±3.21） cm^2, （37.24±0.02） cm, （45.23±0.12） cm/s was higher than that of the control group （20.58±1.24）points, （52.46±2.83） cm^2, （33.53±0.02） cm, （36.53±0.10） cm/s,the difference,was statistically signficant（t=15.423, 16.198, 829.581,352.253, P〈 0.05）, while the MAS score and plantar pressure were （2.43±0.32） points and （79.34±3.76） N/cm^2, which were significantly lower than those of the control group （3.04±0.41） points, （86.23±4.13） N/cm^2,the difference,was statistically signficant（t= 7.418, 7.802, P〈0.05）. One patient with muscle numbness in the observation group had a total complication rate of 2.50%, which was significantly lower than 25.00% of the control group. There was a statistically significant difference in safety be- tween the two groups （X^2=8.538, P〈0.05）. Conclusion The application of extracorporeal shock wave in the treatment of calf triceps tendon in children with spastic cerebral palsy is excellent in its efficacy, reducing its convulsions, improving its exercise capacity, and increasing the area of plantar support, and it is safe and worthwhile promotion in the clinic.