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[目的]探讨采用患肢畸形矫正术、颈总动脉周围交感神经网剥离术治疗混合性脑瘫的疗效。[方法]对86例混合性脑瘫病人随机分为A组50例、B组36例,A组采取患肢畸形矫正术,B组采取颈总动脉周围交感神经网剥离术。术后随访24个月,观察手术肢体痉挛、肌张力障碍及运动功能改善情况。[结果]术后两组病人肌张力障碍均有所改善,A组术后2周Fahn肌张力障碍评分与术前比较明显改善(P≤0.05),B组术后6个月Fahn肌张力障碍评分与术前比较明显改善(P≤0.05),两组之间Fahn肌张力障碍评分术后相比有显著性差异(P≤0.05)。术后两组病人的Rusk康复研究所评分均明显缓解,A、B两组术后12、24个月Rusk康复研究所评分与术前比较明显改善(P≤0.05),两组之间Rusk康复研究所评分术后相比无统计学意义(P≥0.05)。[结论]应用患肢畸形矫正术、颈总动脉周围交感神经网剥离术治疗混合性脑瘫疗效可靠。
[Objective] To investigate the treatment of mixed cerebral palsy by limbal deformity and sympathectomy around common carotid artery. [Methods] 86 patients with mixed cerebral palsy were randomly divided into group A (n = 50) and group B (n = 36). Group A received limb deformity correction. Group B received sympathectomy around the common carotid artery. The patients were followed up for 24 months. The improvement of limb spasm, dystonia and motor function were observed. [Results] The dystonia was improved in both groups after operation. The scores of Fahn dystonia in group A at 2 weeks after operation were significantly improved compared with that before operation (P≤0.05), and at 6 months after operation in group B, Fahn dystonia The score was significantly improved compared with that before operation (P≤0.05). There was significant difference between the two groups in postoperative Fahn dystonia scores (P≤0.05). The Rusk Rehabilitation Institute scores were significantly relieved in both groups after operation, and the scores of Rusk Rehabilitation Institute at 12 and 24 months after operation in Group A and B were significantly improved compared with that before operation (P≤0.05). The Rusk Rehabilitation There was no significant difference between the two groups (P> 0.05). [Conclusion] The treatment of mixed cerebral palsy with limbal deformity and sympathectomy around the common carotid artery is reliable.