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目的 观察 A型肉毒毒素 ( BTX- A)治疗脑血管病 ( CVD)后肌痉挛的疗效和安全性。方法 使用国产 BTX- A局部注射治疗 4 2例 CVD后肌痉挛患者。注射剂量、位点数根据受累肌肉大小、多少及痉挛程度采取个体化原则 ,注射部位按照解剖学体表标志定位。观察注射前后肢体肌力、肌张力 (改良 Ashworth评分 )及功能等改变。结果 注射后患肢肌张力改良 Ashworth评分、步速、步长 ,踝关节活动度均较治疗前明显改善 ( P<0 .0 1、P<0 .0 1、P<0 .0 5、P<0 .0 1) ;注射后 12 .12 % ( 4 /3 3 )患者出现轻度下肢无力 ,持续 4～ 6周后自行好转。结论 BTX- A局部注射是治疗 CVD后肌痉挛的一种安全、简便的有效方法 ,副作用少
Objective To observe the efficacy and safety of botulinum toxin type A (BTX-A) in the treatment of muscle spasm after cerebrovascular disease (CVD). Methods Local BTX-A injection was used to treat 42 patients with post-CVD muscle spasm. Injection dose, site number according to the size of the affected muscle, how much and spasticity to take the principle of individuality, injection site in accordance with the anatomical body surface markers positioning. Before and after injection of limb muscle strength, muscle tone (modified Ashworth score) and functional changes. Results The Ashworth score, gait speed, step length and ankle joint mobility of the limbs after injection improved significantly compared with those before treatment (P <0.01, P <0.01, P <0.05, P <0. 01). 12.12% (4/3 3) of patients showed mild lower extremity weakness after the injection and continued to improve after 4 to 6 weeks. Conclusions BTX-A local injection is a safe, simple and effective method for the treatment of post-CVD muscle spasms with few side effects