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讨论脑卒中后神经康复领域应用A型肉毒毒素治他疗痉挛的问题 ,通过回顾临床研究对目标人群的相关技术资料 ,包括用A型肉毒毒素治疗痉挛的有益与不利因素 ,可以认为肌肉注射 5 0 0～ 15 0 0UDysport或者 10 0～ 30 0UBotox可降低上肢屈肌、下肢伸肌的痉挛。肌张力下降、疼痛解除、手与步行功能提高及患者对药物耐受性好是其主要的益处。另外 ,注射后进行自主活动、电刺激以及石膏、夹板等矫形能强化昂贵的肉毒毒素的疗效。至于A型肉毒毒素的作用机制 ,可认为是梭内外肌纤维的局部麻痹改变了肌肉传入冲动的释放。
To discuss the application of botulinum toxin type A in the treatment of post-stroke neuro-rehabilitation to treat spasms, and to review the clinical data of the target population, including the beneficial and unfavorable factors of treating spasms with botulinum toxin type A, the muscle Injection of 500 ~ 150UDUDPORT or 100 ~ 30UBotox can reduce upper extremity flexor, lower extremity extensor spasm. Decreased muscle tone, pain relief, increased hand and walking support, and good patient tolerance are major benefits. In addition, autonomic activity after injection, electrical stimulation and gypsum, splint and other orthopedic can strengthen the efficacy of expensive botulinum toxin. As for the mechanism of action of botulinum toxin type A, it can be considered that local paralysis of intramuscular and extra-muscular fibers changes the release of muscle afferent impulses.