文章摘要
马善新,许建文,马楠,林伟山,付水生,陶广林.超声引导下重复A型肉毒毒素注射治疗联合综合康复训练对卒中后下肢痉挛的疗效观察[J].中国康复,2019,34(11):567-570
超声引导下重复A型肉毒毒素注射治疗联合综合康复训练对卒中后下肢痉挛的疗效观察
Efficacy of repeated injection of botulinum toxin type A under ultrasound guidance combined with comprehensive rehabilitation for lower limb spasticity in post-stroke patients
  
DOI:
中文关键词: A型肉毒毒素  痉挛  超声引导  脑卒中
英文关键词: botulinum toxin type A  spasticity  ultrasound guidance  stroke
基金项目:广西壮族自治区康复临床重点专科建设项目经费资助(桂卫医发﹝2018﹞6号);广西医药卫生基金(Z20190845)
作者单位
马善新 广西医科大学第一附属医院康复医学科南宁 530021 
许建文 广西医科大学第一附属医院康复医学科南宁 530021 
马楠 山东省东营市东营区人民医院山东 东营 257000 
林伟山 广西医科大学第一附属医院康复医学科南宁 530021 
付水生 广西医科大学第一附属医院康复医学科南宁 530021 
陶广林 广西医科大学第一附属医院康复医学科南宁 530021 
摘要点击次数: 1217
全文下载次数: 877
中文摘要:
      目的: 探讨超声引导下重复A型肉毒毒素(BTX-A)注射治疗联合综合康复训练对卒中后患者下肢痉挛的疗效。方法: 将128名脑卒中患者随机分为观察组和对照组各64例,对照组患者进行综合康复训练,观察组患者在此基础上再配合重复BTX-A注射治疗,治疗前与治疗3个周期(每个周期为4周)后分别统计2组患者佩戴矫形器的情况,采用改良Ashworth 肌张力评定量表(MAS)、10米步行测试(10MWT)、Fugl-Meyer运动功能评定量表(FMA)进行评定。结果:治疗3个周期后,观察组佩戴踝足矫形器均明显低于对照组和治疗前(均P<0.05); 2组患者治疗第1周期、第2周期和第3周期后与组内治疗前比较,MAS评分和10MWT均显著降低(均P<0.05),FMA评分明显提高(P<0.05);治疗第1周期、第2周期和第3周期后,2组同时间点比较,观察组患者MAS评分和10MWT均明显低于对照组(均P<0.05),FMA评分明显高于对照组(P<0.05)。结论: 重复BTX-A注射治疗联合综合康复训练可持续改善患者的下肢痉挛程度及运动功能;治疗前表现为前倾步态模式并佩戴踝足矫形器行走的患者经BTX-A治疗联合综合康复训练后有望丢弃支具独立行走。
英文摘要:
      Objective: To study the efficacy of repeated injection of botulinum toxin type A (BTX-A) under ultrasound guidance combined with comprehensive rehabilitation for lower limb spasticity in post-stroke patients. Methods: A total of 128 stroke patients were divided into observation group and control group, with 64 patients in each group. Patients in both groups received comprehensive rehabilitation training, and those in the observation group were given BTX-A treatment additionally. Before and after 3 cycles of treatment, the wearing of orthopedic devices in the 2 groups was surveyed, and Modified Ashworth Scale (MAS), 10-meter walking test (10MWT) and Fugl-Meyer motor function assessment (FMA) were used. Results: After 3 cycles of treatment, the wearing rate of ankle-foot orthopedic device in the observation group was significantly lower than that in the control group and before treatment (all P<0.05). After the first, second and third cycles of treatment, MAS scores and 10MWT scores were significantly reduced (all P<0.05), while FMA scores were significantly increased (P<0.05). After the first, second and third cycles of treatment, the MAS scores and 10MWT scores in the observation group were significantly lower (both P<0.05), and the FMA scores were significantly higher than those in the control group (P<0.05). Conclusions: Repeated injection of BTX-A combined with comprehensive rehabilitation can continuously improve lower limb spasticity in post-stroke patients. Our results suggest that patients who show the forward gait pattern prior to therapy and walk with plastic ankle-foot orthosis may be expected to discontinue the use of their plastic ankle-foot orthosis after therapy.
查看全文   下载PDF阅读器  HTML全文
关闭
本刊微信二维码