文档介绍：A型肉毒毒素治疗痉挛性小儿脑瘫的疗效观察
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【摘要】目的探讨A型肉毒毒素(BTA)对痉挛性小儿脑瘫的临床疗效。方法根据纳入标准,选择30例患儿作为观察对象,采用BTA肌肉注射,剂量为2~5 u/kg。疗效评定:肌张力采用改良的Ashworth法评价、PRS(Physician Rating Scale)评分,并进行统计学处理。结果 29例治疗后较治疗前症状明显改善,其PRS指标治疗前后比较差异显著();按Ashworth分级,30例中,治疗前最高5级,最低2级,平均4级。注射后除一例无效外,肌张力降为最高4级,最低1级,平均2级。治疗中及治疗后无明显副作用发生。结论 BTA治疗痉挛性小儿脑瘫,副作用小,方法简单,刺激性小,维持有效时间长。BTA是改善小儿脑瘫肌痉挛和肢体功能的一种实用性的治疗选择。
【关键词】 A型肉毒毒素;痉挛性脑瘫;治疗
[Abstract] Objective To observe the clinical value of botulinus toxin A on the treatment of spastic cerebral palsy for Thirty children were injected with BTA for spasticity treatment,the dosage was 2~5 u/kg; the therapeutic efficacy was evaluated by physician rating scale(PRS) and dystonia was evaluated by improved Ashworth and the result was done with statistical 29 cases was obviously improved in symptoms after obvious side effects were found during and after BTX-A proves to be a simple,safe and effective method in the treatment of the spastic cerebral short,it is a useful therapeutic option.
[Key words] botulinus toxin,type A;spastic cerebral palsy;therapy
在脑瘫中痉挛性脑瘫占60%~70%[1],病变波及锥体束系统,肌张力增高,表现为运动功能障碍、姿势异常和关节挛缩畸形。由于痉挛限制了患儿的运动范围,可诱发形成固定化的异常姿势和关节挛缩,导致疼痛,从而引发一系列生物力学及形态学改变,进一步加重对移动能力的限制,因此在临床治疗痉挛性脑瘫患儿时降低肌张力是治疗的关键之一。目前对降低肌张力的治疗手段主要有传统关节活动度训练、低频电治疗、药物和手术等治疗[2]。我们在以康复功能训练为主要治疗