推拿按摩联合曲安奈德治疗小儿先天性肌性斜颈疗效观察

Therapeutic effect of massage combined with triamcinolone acetonide in the treatment of congenital muscular torticollis in children

目的观察推拿按摩联合曲安奈德治疗先天性肌性斜颈患儿的疗效。方法选择2018年1月至2020年10月深圳市宝安区妇幼保健院收治的76例先天性肌性斜颈患儿进行前瞻性研究,按照随机数表法分为观察组和对照组各38例。对照组患儿给予推拿按摩治疗,观察组患儿在对照组基础上联合曲安奈德治疗,均连续治疗6个月。比较两组患儿治疗6个月后的临床疗效,治疗前、治疗6个月后的胸锁乳突肌包块厚度、挛缩长度和颈部活动度、头部倾斜度、面部畸形度、肌肉紧张度、超声检查结果评分以及治疗期间的不良反应发生情况。结果治疗后,观察组患儿的临床疗效优良率为92.11%,明显高于对照组的73.68%,差异有统计学意义(P<0.05);治疗后,观察组患儿的胸锁乳突肌包块厚度、挛缩长度分别为(4.57±0.86)mm、(4.73±0.62)mm,明显短于对照组的(6.32±0.73)mm、(6.51±1.16)mm,差异均有统计学意义(P<0.05);治疗后,观察组患儿的颈部活动度、头部倾斜度、面部畸形度、肌肉紧张度、超声检查结果评分分别为(2.07±0.23)分、(2.01±0.25)分、(2.72±0.16)分、(1.93±0.22)分、(2.03±0.17)分,明显高于对照组的(1.59±0.18)分、(1.42±0.20)分、(2.16±0.23)分、(1.30±0.18)分、(1.50±0.18)分,差异均有统计学意义(P<0.05);两组患儿治疗期间均无严重不良现象发生。结论推拿按摩联合曲安奈德治疗先天性肌性斜颈患儿的效果显著,值得临床推广。

Objective To study the effect of massage combined with triamcinolone acetonide in the treatment of congenital muscular torticollis.Methods A total of 76 children with congenital muscular torticollis treated in Shenzhen Bao'an District Maternal and Child Health Hospital from January 2018 to October 2020 were selected for a prospective study.They were randomly divided into an observation group and a control group,with 38 patients in each group.The control group was treated with massage,while the observation group was treated with triamcinolone acetonide on the basis of the control group,all for 6 months.The clinical effect at 6 months after treatment,the sternocleidomastoid muscle lump thickness and contracture length and the scores of neck motion,head tilt,facial deformity,muscle tension,ultrasound results,the incidence of adverse reactions during treatment at before and 6 months after treatment between the two groups were compared.Results After treatment,the excellent and good rate of clinical efficacy in the observation group was 92.11%,which was significantly higher than 73.68% in the control group(P<0.05).After treatment,the sternocleidomastoid muscle lump thickness,and contracture length in the observation group were(4.57±0.86)mm,and(4.73±0.62)mm,which were significantly shorter than(6.32±0.73)mm and(6.51±1.16)mm in the control group(P<0.05).After treatment,the scores of neck motion,head tilt,facial deformity,muscle tension,ultrasound results in the observation group were(2.07±0.23)points,(2.01±0.25)points,(2.72±0.16)points,(1.93±0.22)points,(2.03±0.17)points,which were significantly higher than(1.59±0.18)points,(1.42±0.20)points,(2.16±0.23)points,(1.30±0.18)points,and(1.50±0.18)points in the control group(P<0.05).There was no serious adverse reactions between the two groups during the treatment.Conclusion Massage combined with triamcinolone acetonide is effective in the treatment of children with congenital muscular torticollis,which is worthy of clinical promotion.