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目的:研究偏瘫患者肌痉挛发生情况及其危险因素,为偏瘫肌痉挛的临床防治提供有利依据。方法:回顾性调查158例脑梗塞、脑出血和颅脑外伤患者的临床资料,对可能发生肌痉挛的相关因素进行分析。结果:颅脑相关手术(去骨瓣减压术、颅内血肿清除术)、情绪障碍及亢进的腱反射与肌痉挛的发生有密切关系,P值分别为0.039、0.023和0.001(P均<0.05);弥漫性轴索损伤患者肌痉挛发生率为100.0%(总共收集到4例,全部为肌痉挛患者);单独的海马梗塞和丘脑出血可以引起肌张力增高。结论:颅脑相关手术(去骨瓣减压术、颅内血肿清除术)、情绪障碍、亢进的腱反射、弥漫性轴索损伤为肌痉挛发生的危险因素,临床上属于这类损伤的偏瘫患者要预防肌痉挛的发生,已发生肌痉挛的患者要积极针对以上危险因素进行治疗。
Objective: To study the occurrence and risk factors of muscle spasm in patients with hemiplegia and provide a favorable basis for clinical prevention and treatment of hemiplegia muscle spasm. Methods: The clinical data of 158 patients with cerebral infarction, cerebral hemorrhage and craniocerebral trauma were retrospectively analyzed, and the related factors of muscle spasm were analyzed. Results: There was a close relationship between tendon reflexes of craniocerebral involvement surgery (decompressive craniectomy, intracranial hematoma), mood disorders and hyperthyroidism and the occurrence of muscle spasm. The P values were 0.039, 0.023 and 0.001 (P < 0.05). The incidence of muscle spasm in patients with diffuse axonal injury was 100.0% (a total of 4 patients were collected, all of whom were patients with muscle spasms); hippocampal infarction and thalamic hemorrhage alone could cause increased muscle tone. Conclusion: Brain-related surgery (decompressive craniectomy, intracranial hematoma removal), mood disorders, hyperthyroidism, tendon reflex, diffuse axonal injury as a risk factor for muscle spasm, clinically belongs to this type of injury hemiplegia Patients to prevent the occurrence of muscle spasm, muscle spasms have occurred in patients with active treatment for the above risk factors.