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目的研究显微镜下选择性胫神经肌支切断术对成人和儿童脑瘫患者痉挛足的临床治疗效果。方法以该院在2010年1月—2016年3月收治的30例48肢体脑瘫痉挛足患者作为研究对象,其中成人15例(23肢),儿童15例(25肢)。对所有的患者均在显微镜下通过选择性胫神经肌支切断术进行治疗,在手术以后指导患者进行康复训练,同时还需要对患者进行回访。比较成人和儿童的治疗满意度,比较成人和儿童在改良Ashworth量表、踝阵挛指数、踝关节被动背伸幅度的评分。结果儿童的临床治疗满意度为100.0%,成人的临床治疗满意度为93.3%,两者之间差异无统计学意义;在改良Ashworth评分、踝阵挛指数、踝关节被动背伸幅度的评分,儿童的改善程度明显优于成人,两者之间差异有统计学意义(P<0.05)。结论使用显微镜下选择性胫神经肌支切断术能够有效的实现对成人和儿童脑瘫患者痉挛足的治疗,两者相比较而言,儿童术后恢复情况更好,
Objective To study the clinical effect of microsurgical selective tibial nerve myotomy on spasticity in adults and children with cerebral palsy. Methods Thirty patients (48 limbs with cerebral palsy spasm) admitted to our hospital from January 2010 to March 2016 were enrolled. Among them, 15 were adults (23 limbs) and 15 were children (25 limbs). All patients underwent microsurgical treatment of selective tibiofemoral muscular branchctomy, guiding patients for rehabilitation after surgery, and also required patient visits. The treatment satisfaction of adults and children was compared and scores of adults and children were compared on a modified Ashworth scale, ankle clonus index, and ankle passive dorsiflexion scale. Results The satisfaction rate of clinical treatment was 100.0% in children and 93.3% in adults. There was no significant difference between the two groups. The modified Ashworth score, ankle clonus index, the score of ankle passive dorsiflexion, Children improved significantly better than adults, the difference between the two was statistically significant (P <0.05). Conclusion The use of microsurgical selective tibial nerve myotomy can effectively treat spasmodic foot in adults and children with cerebral palsy. Compared with the control group, the recovery of children after operation is better,