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目的通过分析颈总动脉交感神经网剥脱术后手足徐动型脑瘫患儿双手精细运动能力和粗大运动功能改变情况,探讨该术式对脑瘫患儿运动功能的影响。方法选取2014-03-2015-05在新疆医科大学第二附属医院就诊的手足徐动型脑瘫患儿作为受试对象,按性别、年龄及病情严重程度相近的原则两两配对,分为实验组、对照组。实验组患儿实施颈总动脉交感神经网剥脱术,对照组不行任何治疗,回家正常养育,随访6个月。分别在术前、术后6个月时根据手功能分级(Manual Ability Classification System,MACS)、精细运动功能评定量表(Fine Motor Function Measure scale,FMFM)和粗大运动功能测试量表(Gross Motor Function Measure,GMFM-66)评定患儿运动功能。结果术后6个月时实验组MACS、FMFM评分较术前明细提高(P<0.05),对照组MACS、FMFM评分较术前无明显改善(P>0.05);术后6个月时实验组GMFM-66评分随有所提高,但差异无统计学意义(t=2.168,P=0.058>0.05)。而对照组GMFM-66评分较术前无明显改善(t=0.822,P=0.432>0.05)。结论对手足徐动型脑瘫患儿实施颈总动脉交感神经网剥脱术,可明显提高其双手精细动作能力,但在粗大运动方面的得疗效不确切,也可能与本研究样本量较小有关,有待后续进一步研究。
Objective To analyze the changes of fine motor function and gross motor function of both hands in children with cerebral athemia after carotid artery sympathetic nerve network exfoliation and to explore the effect of the operation on the motor function of children with cerebral palsy. Methods 2014-03-2015-05 Children with AS in the Second Affiliated Hospital of Xinjiang Medical University were enrolled in this study. The children were divided into two groups according to their gender, age and severity. , Control group. In the experimental group, the common carotid artery sympathetic nerve network was performed in the control group, and no treatment was given in the control group. The patients were nourished normally and were followed up for 6 months. According to Manual Ability Classification System (MACS), Fine Motor Function Measure scale (FMFM) and Gross Motor Function Measure, GMFM-66) to assess children’s motor function. Results The score of MACS and FMFM in experimental group increased significantly (P <0.05) at 6 months after operation, while the score of MACS and FMFM in control group had no significant improvement compared with that before operation (P> 0.05). At 6 months after operation, The score of GMFM-66 increased with the increase, but the difference was not statistically significant (t = 2.168, P = 0.058> 0.05). The control group, GMFM-66 score no significant improvement compared with preoperative (t = 0.822, P = 0.432> 0.05). Conclusions The implementation of common carotid artery sympathetic nerve network exfoliation in children with hand-foot-beating cerebral palsy can significantly improve the fine motor ability of both hands, but the curative effect in gross motor is not exact and may be related to the small sample size in this study. Pending further study.