肌电图引导下A型肉毒素与选择性脊神经后根切断术治疗痉挛型脑瘫的效果比较

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Abstract Objective To study the effect of electromyography-guided botulinum toxin type A and selective posterior rhizotomy (SPR) for treatment of spastic cerebral palsy. Methods The clinical data of 40 patients with spastic cerebral palsy were retrospectively analyzed from December 2015 to June 2016 in the Cerebral Palsy Center, the Second Affiliated Hospital of Xinjiang Medical University. According to the treatment method, these patients were divided into the observation group and the control group. There were 20 cases treated with electromyogram-guided botulinum toxin type A in the control group. And there were 20 cases treated with SPR in the observation group. The postoperative complications, the comprehensive spasticity scale (CSS) and the gross motor function scale (GMFM) at different time before and after treatment were compared between the two groups. Results There was no statistical significance between two groups (P ＞ 0.05). Two weeks after treatment, the CSS score in the observation group began to decrease. One month after treatment, the CSS score in the control group began to decline. At 2 weeks, 1 month, 3 months and 6 months after treatment, the scores of CSS in the observation group were significantly lower than those in the control group and decreased degree in the observation group were more than those in the control group, with statistically significant difference (P ＜ 0.05). One month after treatment, the GMFM score in the observation group began to increase. Three months after treatment, the GMFM score in the control group began to increase. At 1 month, 3 months and 6 months after treatment, the GMFM score in the observation group were significantly more than those in the control group and increased degree in the observation group were more than those in the control group, with statistically significant difference (P ＜ 0.05). At 1 month and 3 months after treatment, MAS score for triceps surae and the motion of ankle-joint were significantly improvement compared with those before treatment (P ＜ 0.05), and the improvement for MAS score of triceps surae and the motion of ankle-joint in the observation group were more than those in the control group, with statistically significant difference (P ＜ 0.05). Conclusion Electromyography guided botulinum toxin type A and SPR for treatment of spastic cerebral palsy are effective and safe. Based on strict operative indications, the latter has advantages of relieving muscle spasm and improving the children's motor capacity.

Key words： Spastic cerebral palsy Electromyography Botulinum toxin type A Selective posterior rhizotomy

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	Aikebaier·Halike LU Xia Mutalifu·Lureihamaiti XU Jian YAN Baofeng Maieraba XU Jufang LUAN Xinping▲

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Aikebaier·Halike LU Xia Mutalifu·Lureihamaiti XU Jian YAN Baofeng Maieraba XU Jufang LUAN Xinping▲. Comparative study on spastic cerebral palsy treated by lectromyography-guided botulinum toxin type A and selective posterior rhizotomy[J]. 中国医药导报, 2017, 14(17): 54-57.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2017/V14/I17/54

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