肉毒素注射结合高分子绷带固定治疗痉挛型脑瘫尖足的临床研究

Clinical Study of Botulinum Toxin Injection Combined with Polymer Bandage Fixation for Spastic Cerebral Palsy Acute Foot

目的 探究采用肉毒素注射结合高分子绷带固定治疗痉挛型脑瘫尖足的效果。方法 将云南省曲靖市妇幼保健院2019年4月—2020年4月期间收治的50例痉挛型脑瘫尖足患儿随机均分为对照组与治疗组,各25例。对照组患儿给予肉毒素注射及康复训练,治疗组在肉毒素注射及康复训练的基础上给予高分子绷带固定治疗,对比两组患儿治疗前后足背屈角角度、综合痉挛程度及粗大运动功能。结果 治疗前两组患儿各项指标对比,差异无统计学意义(P>0.05);经治疗后,相较于对照组患儿而言,治疗组患儿肌张力显著降低,足背屈角角度、CSS评分以及GMFM-88评分分别为(-15.77±6.84)°(9.16±1.80)分、(62.34±3.66)分相较于对照组患儿(-29.53±5.76)°(11.25±2.04)分、(50.65±3.57)分均显著改善,差异有统计学意义(t=7.694、3.841、11.432,P<0.05)。结论 对痉挛型脑瘫尖足患儿采用肉毒素注射技术结合高分子绷带固定能够取得十分显著的临床效果,更好地保障患儿恢复健康,同时药物采购的成本较低,对患儿家属造成的经济负担较小。

Objective To investigate the effect of using botulinum toxin injection combined with polymer bandage fixation in the treatment of spastic cerebral palsy acute foot.Methods 50 children with spastic cerebral palsy acute foot admitted to Qujing Maternal and Child Health Hospital between April 2019 and April 2020 were randomly and equally divided into a control group and a treatment group,25 cases each.The children in the control group were given botulinum toxin injection and rehabilitation training,while the children in the treatment group were given polymer bandage fixation treatment on the basis of botulinum toxin injection and rehabilitation training.The foot dorsiflexion angle,the degree of integrated spasticity,and gross motor function were compared between the two groups before and after treatment.Results The differences in the indexes of the children in the 2 groups before treatment were not statistically significant(P>0.05);after treatment,the muscle tone of children in the treatment group decreased significantly after 6 month of treatment compared with that of children in the control group.The foot dorsiflexion angle,CSS score and GMFM-88 score were(-15.77±6.84)°,(9.16±1.80) points and(62.34±3.66) points,respectively,after treatment,which were significantly improved compared with(-29.53±5.76)°,(11.25±2.04) points and(50.65±3.57) points in the control group,the difference was statistically significant(t=7.694,3.841,11.432,P<0.05).Conclusion The use of botulinum toxin injection technique combined with polymer bandage fixation for children with spastic cerebral palsy acute foot can achieve very significant clinical results and better ensure the recovery of the child's health,while the cost of drug procurement is low and the economic burden to the child's family is small.