石墨烯温热外展矫形器对痉挛型脑瘫患儿髋关节发育的影响

Effect of Graphene Warm Abduction Orthosis on Hip Joint Development in Children with Spastic Cerebral Palsy

目的:观察石墨烯温热外展矫形器对痉挛型脑瘫患儿髋关节发育的影响。方法:将28例(56髋)2~10岁的痉挛型脑瘫患儿采用随机数字表法分为对照组和治疗组,其中5例(10髋)退出研究,最终对照组12例(24髋)和治疗组11例(22髋)。2组均接受常规康复训练,在此基础上对照组进行内收肌外展牵拉治疗,治疗组佩戴石墨烯温热外展矫形器。治疗时内收肌最小角度>30°,每天训练时间1~2 h,共治疗2个月。分别在治疗前后测量2组患儿股骨头偏移百分比(MP)、髋臼指数(AI)、颈干角(NSA)、粗大运动功能评定量表(GMFM)和改良Tardieu量表(MTS),并计算其差值。根据以上指标比较2组的疗效。结果:对照组治疗后GMFM(49.90±13.08)较治疗前(47.67±3.56)明显改善(P<0.05),MP、AI及MTS与治疗前比较差异无统计学意义(P>0.05),治疗后NSA(156.92±9.31)°较治疗前(149.00±8.07)°明显改善(P<0.05)。治疗组MP、AI、GMFM及MTS治疗后分别为(26.82±12.44)%、[15.00(13.75,19.00)]°、(55.96±0.12)、(26.12±7.49)°优于治疗前的(31.93±11.37)%、[17.50(13.00,21.00)]°、(51.79±9.15)、(19.09±8.93)°,差异均有统计学意义(P<0.05);治疗后NAS(152.20±8.72)°较治疗前(154.27±1.03)°相比,差异无统计学意义(P>0.05)。治疗组d-MP[3.75(0.09,10.61)]%、d-NAS(2.28±9.54)°、d-GMFM(-3.80±1.97)与对照组的[0.00(-3.70,2.80)]%、(-7.90±8.63)°、(-2.14±1.60)相比较,差异有统计学意义(P<0.05),dAI和d-MTS值差异无统计学意义(P>0.05)。结论:石墨烯温热外展矫形器可以有效改善脑瘫患儿髋关节脱位或半脱位,并可延缓其进展,改善粗大运动功能。

Objective:To observe the effect of graphene warm abduction orthosis on hip joint development in children with spastic cerebral palsy.Methods:A total of 28 children(56 hips)aged 2-10 years with spastic cerebral palsy were randomly divided into two groups by random number table method.There were 12 cases(24 hips)enrolled in the control group,11 cases(22 hips)enrolled in the treatment group,and 5 cases(10 hips)withdrew from the study.Both groups received routine rehabilitation training.Additionally,the control group underwent adductor abduction traction training,and the treatment group wore graphene warm abduction orthosis.During the training,the adductor angle was at least>30°,the training time was 1-2 hours per day,and the treatment continued for 2 months.The migration percentage(MP),acetabular index(AI),neck shaft angle(NSA),gross motor function measure(GMFM)and modified Tardieu scale(MTS)were measured before and after treatment,and the differences were calculated.Results:Compared with before treatment(47.67±3.56),the GMFM(49.9±13.08)after treatment in the control group significantly improved(P<0.05),and the change of MP,AI and MTS were not significant(P>0.05),and NAS(152.20±8.72)°was progressing(154.27±1.03)°(P<0.05).In the treatment group,MP,AI,GMFM and MTS after treatment were(26.82±12.44)%,[15.00(13.75,19.00)]°,(55.96±0.12),and(26.12±7.49)°,respectively,better than those before treatment(31.93±11.37)%,[17.50(13.00,13.00),21.00]°,(51.79±9.15),(19.09±8.93)°,the differences were statistically significant(P<0.05).There was no significant difference in NAS(152.20±8.72)°after treatment compared with that(154.27±1.03)°before treatment(P>0.05).The d-MP[3.75(0.09,10.61)]%,d-NAS(2.28±9.54)°and d-GMFM(-3.80±1.97)of the treatment group were compared with those of the control group[0.00(-3.70,2.80)]%,(-7.90±8.63)°,(-2.14±1.60),the differences were statistically significant(P<0.05),while the d-AI and d-MTS were not statistically significant(P>0.05).Conclusion:The graphene warm abduction orthosis can effectively improve hip dislocation or subluxation in children with spastic cerebral palsy,delay its progression,and improve the gross motor function.