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目的观察多点靶肌注射A型肉毒毒素治疗痉挛型脑性瘫痪(脑瘫)患儿是否比非多点靶肌注射有更好的效果。方法于2013年2月-10月将42例患儿按接受治疗的先后顺序编号,编号为单数的患儿纳入多点靶肌注射组(A组),编号为偶数的患儿纳入非多点靶肌普通注射组(B组),每组21例,进行A型肉毒毒素注射治疗。采用对照研究的方法,对两组患儿在治疗前及治疗后2周、1个月和3个月进行改良Ashworth评分(MAS),观察其踝关节在伸膝和屈膝时的背屈度,采用多水平统计方法进行分析。结果两组患儿在接受治疗后其踝关节在伸膝和屈膝时的背屈度、MAS评分都有明显进步(P<0.05),而测量时间与组别无交互作用,两组间的差异无统计学意义(P>0.05)。结论 A型肉毒毒素能缓解脑瘫患儿痉挛的肌肉,改善被动关节活动度和运动功能。尚不能认为多点靶肌注射比非多点靶肌注射A型肉毒毒素治疗痉挛型脑瘫患儿具有更好的疗效。
Objective To observe whether multi-target target muscle injection of botulinum toxin type A is better than non-multipoint target muscle injection in children with spastic cerebral palsy (cerebral palsy). Methods From February to October 2013, 42 infants were enrolled according to the sequence of treatment. The children with single number were included in the multi-target target muscle injection group (group A). The even numbered children were included in non-multi-point Target muscle injection group (B group), 21 cases in each group, botulinum toxin type A injection therapy. The control group was used to evaluate the modified Ashworth score (MAS) before treatment, 2 weeks, 1 month and 3 months after treatment. The ankle flexion, Using multi-level statistical methods for analysis. Results After treatment, the flexion and MAS scores of knee ankles in both groups were significantly improved (P <0.05), while the measurement time did not interact with the groups. The differences between the two groups No statistical significance (P> 0.05). Conclusion Botulinum toxin type A can relieve the spastic muscles in children with cerebral palsy and improve the passive joint mobility and motor function. It can not be considered that multi-target target muscle injection has a better effect than non-multi-target target muscle injection botulinum toxin type A in treating children with spastic cerebral palsy.