ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2016, Vol. 8 ›› Issue (4): 432-435.doi: 10.3969/j.issn.1674-3865.2016.04.020

• 临床研究 • 上一篇    下一篇

A型肉毒毒素联合石膏固定对痉挛型双瘫患儿粗大运动功能影响的疗效观察

蔡慧强，彭桂兰，胡恕香，蔡淑英   

  1. 361000 厦门，厦门市妇幼保健院儿童神经康复科
  • 出版日期:2016-08-25 发布日期:2018-11-19
  • 通讯作者: 蔡慧强，E-mail：406228762@qq.com
  • 作者简介:蔡慧强(1984-)，男，主治医师。研究方向：儿童神经康复

Effect of botulinum toxin A combined with plaster cast on gross motor function of spasmodic double paralysis

CAI Huiqiang，PENG Guilan，HU Shuxiang，CAI Shuying   

  1. Xiamen Maternal and Child Healthcare Hospital，Xiamen 361000，China.
  • Online:2016-08-25 Published:2018-11-19

PDF (PC)

123

摘要：
目的：观察A型肉毒毒素联合石膏固定对痉挛型双瘫患儿粗大运动功能的影响。
方法：2013年1月至2014年10月厦门市妇幼保健院儿童神经康复科收治住院的痉挛型双瘫患儿40例，随机分为观察组和对照组各20例。对照组单纯采用A型肉毒毒素注射后进行康复训练；观察组采用A型肉毒毒素注射联合石膏固定3周，拆除石膏后进行康复训练，分别于治疗前及治疗后1、3、6个月采用粗大运动功能量表(GMFM-88)D区和E区进行评估。
结果：观察组治疗后1、3、6个月GMFM-88 D区、E区与治疗前比较差异有统计学意义(P<0.01)。对照组治疗后3、6个月GMFM-88 D区、E区与治疗前比较差异有统计学意义(P<0.01)。观察组治疗后1、3、6个月GMFM-88 D区、E区与对照组比较差异有统计学意义(P<0.01)。
结论：A型肉毒毒素注射联合石膏固定治疗痉挛型双瘫患儿尖足畸形，可降低肌张力，改善运动功能，有效提高粗大运动功能，比单纯采用A型肉毒毒素治疗疗效更好。

关键词: 痉挛型双瘫, 粗大运动功能, A型肉毒毒素, 儿童

Abstract:


Objective：To explore the effect of botulinum toxin A combined with plaster cast on the gross motor function of spasmodic double paralysis.
Methods：A total of 40 children with spasmodic double paralysis hospitalized in Xiamen Maternal and Child Healthcare Hospital from Jan. 2013 to Oct. 2014 were included in the study, and they were randomly divided into two groups:observation group(20 cases) and control group(20 cases). Control group was treated only with botulinum toxin A injection followed by rehabilitation training. Observation group was given with botulinum toxin A combined with 3 weeks of plaster cast, and then rehabilitation training was carried out after removing the plaster. GMFM-88 was used to make evaluation of zone D and zone E before treatment and 1,3 and 6 months after treatment.
Results：Zone D and E was different 1,3 and 6 months after treatment by GMFM-88 in the observation group, compared with that before treatment, the difference being statistical(P<0.01). Zone D and E showed statistical difference 3 and 6 months after treatment in the control group compared with before treatment(P<0.01). Zone D and E showed statistical difference between observation and control group 1,3 and 6 months after treatment(P<0.01).
Conclusion：Botulinum toxin A injection combined with plaster cast is effective in treating pointed foot deformity of spasmodic double paralysis, and it can reduce muscle tone, improve motion function and effectively improve gross motion function, which is better than single use of botulinum toxin A.

Key words: Spasmodic double paralysis, Gross motor function, Botulinum toxin A, Child