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目的探讨A型肉毒毒素(BTX-A)注射配合康复训练治疗痉挛型脑瘫患儿的疗效。方法选择16例痉挛型脑瘫患儿,进行BTX-A注射,再配合康复训练治疗并设对照组对比观察;于注射前及注射后3d、2周、1个月、3个月采用改良Ashworth痉挛等级量表及粗大运动功能量表(GMFM-88)进行疗效评估。结果起效时间为注射后24～72h,到达高峰时间为1～2周,疗效维持>3月;治疗组治疗后3d,对照组治疗后2周,痉挛评分下降,较治疗前差异有显著性意义(P<0.05);治疗后2周至3个月两组对比差异有显著性意义(P<0.05)或非常显著性意义(P<0.01);治疗后两组GMFM-88评分均有提高,治疗组与对照组相比差异有非常显著性意义(P<0.01);不良反应与剂量相关。结论BTX-A注射配合康复训练治疗可快速缓解脑瘫患儿下肢痉挛的肌肉,改善运动功能,提高临床疗效。
Objective To investigate the efficacy of botulinum toxin type A (BTX-A) injection in combination with rehabilitation training in children with spastic cerebral palsy. Methods Sixteen children with spastic cerebral palsy were selected for BTX-A injection, followed by rehabilitation training and compared with control group. Before and 3, 2 weeks, 1 month and 3 months after injection, a modified Ashworth spasm Grade scale and gross motor function scale (GMFM-88) for efficacy evaluation. Results The onset time ranged from 24 to 72 hours after injection, reaching the peak time of 1 to 2 weeks, and the curative effect maintained for> 3 months. After 3 days of treatment, the spasticity score of control group decreased 2 weeks after treatment, which was significantly different from that before treatment (P <0.05). After 2 weeks and 3 months of treatment, the difference between the two groups was significant (P <0.05) or very significant (P <0.01). After treatment, the GMFM-88 scores increased in both groups, There were significant differences between the treatment group and the control group (P <0.01). Adverse reactions were dose-dependent. Conclusion BTX-A injection combined with rehabilitation training can quickly relieve the muscle of lower extremity spasticity in children with cerebral palsy, improve motor function and improve clinical efficacy.